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Cao J, Donato L, El-Khoury JM, Goldberg A, Meeusen JW, Remaley AT. ADLM Guidance Document on the Measurement and Reporting of Lipids and Lipoproteins. J Appl Lab Med 2024; 9:1040-1056. [PMID: 39225455 DOI: 10.1093/jalm/jfae057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 05/02/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND The accurate measurement of blood lipids and lipoproteins is crucial for the clinical management of atherosclerotic disease risk. Despite progress in standardization, there are still significant variations in pre-analytical requirements, methods, nomenclature, and reporting work flows. CONTENT The guidance document aims to improve standardization of clinical lipid testing work flows. It provides recommendations for the components of the lipid panel, fasting requirements, reporting of results, and specific recommendations for non-high-density lipoprotein cholesterol (non-HDL-C), low-density lipoprotein cholesterol (LDL-C), lipoprotein(a) [Lp(a)], apolipoprotein B (apo B), point-of-care lipid testing, and LDL subfraction testing. SUMMARY Lipid panels should always report non-HDL-C and LDL-C calculations if possible. Fasting is not routinely required except in specific cases. Modern equations should be utilized for LDL-C calculation. These equations allow for LDL-C reporting at elevated concentrations of triglycerides and obviate the need for direct measured LDL-C in most cases.
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Affiliation(s)
- Jing Cao
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Leslie Donato
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Joe M El-Khoury
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Anne Goldberg
- Division of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine, St. Louis, MO, United States
| | - Jeffrey W Meeusen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Alan T Remaley
- Lipoprotein Metabolism Laboratory, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
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Langsted A, Nordestgaard BG. Worldwide Increasing Use of Nonfasting Rather Than Fasting Lipid Profiles. Clin Chem 2024; 70:911-933. [PMID: 38646857 DOI: 10.1093/clinchem/hvae046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/13/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND Historically, lipids and lipoproteins were measured in the fasting state for cardiovascular risk prediction; however, since 2009 use of nonfasting lipid profiles has increased substantially worldwide. For patients, nonfasting lipid profiles are convenient and avoid any risk of hypoglycemia. For laboratories, blood sampling in the morning and extra visits for patients who have not fasted are avoided. For patients, clinicians, hospitals, and society, nonfasting sampling allows same-day visits with first blood sampling followed by a short wait for test results before clinical consultation. Therefore, nonfasting compared to fasting lipid profiles will save money and time and may improve patient compliance with cardiovascular prevention programs. CONTENT We report on the progression of endorsement and implementation of nonfasting lipid profiles for cardiovascular risk prediction worldwide and summarize the recommendations from major medical societies and health authorities in different countries. We also describe practical advantages and disadvantages for using nonfasting lipid profiles. Further, we include a description of why fasting has been the standard historically, the barriers against implementation of nonfasting lipid profiles, and finally we suggest the optimal content of a nonfasting lipid profile. SUMMARY Lipid, lipoprotein, and apolipoprotein concentrations vary minimally in response to normal food intake and nonfasting lipid profiles are equal or superior to fasting profiles for cardiovascular risk prediction. Major guidelines and consensus statements in Europe, the United States, Canada, Brazil, Japan, India, and Australia now endorse use of nonfasting lipid profiles in some or all patients; however, there are still gaps in endorsement and implementation of nonfasting lipid profiles worldwide.
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Affiliation(s)
- Anne Langsted
- Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
- The Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
- Department of Clinical Biochemistry, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
- The Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Stanesby O, Armstrong MK, Otahal P, Goode JP, Fraser BJ, Negishi K, Kidokoro T, Winzenberg T, Juonala M, Wu F, Kelly RK, Xi B, Viikari JSA, Raitakari OT, Daniels SR, Tomkinson GR, Magnussen CG. Tracking of serum lipid levels from childhood to adulthood: Systematic review and meta-analysis. Atherosclerosis 2024; 391:117482. [PMID: 38569384 DOI: 10.1016/j.atherosclerosis.2024.117482] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/15/2024] [Accepted: 02/15/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND AND AIMS The utility of lipid screening in pediatric settings for preventing adult atherosclerotic cardiovascular diseases partly depends on the lifelong tracking of lipid levels. This systematic review aimed to quantify the tracking of lipid levels from childhood and adolescence to adulthood. METHODS We systematically searched MEDLINE, Embase, Web of Science, and Google Scholar in March 2022. The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO; ID: CRD42020208859). We included cohort studies that measured tracking of lipids from childhood or adolescence (<18 years) to adulthood (≥18) with correlation or tracking coefficients. We estimated pooled correlation and tracking coefficients using random-effects meta-analysis. Risk of bias was assessed with a review-specific tool. RESULTS Thirty-three studies of 19 cohorts (11,020 participants) were included. The degree of tracking from childhood and adolescence to adulthood differed among lipids. Tracking was observed for low-density lipoprotein cholesterol (pooled r = 0.55-0.65), total cholesterol (pooled r = 0.51-0.65), high-density lipoprotein cholesterol (pooled r = 0.46-0.57), and triglycerides (pooled r = 0.32-0.40). Only one study included tracking of non-high-density lipoprotein cholesterol (r = 0.42-0.59). Substantial heterogeneity was observed. Study risk of bias was moderate, mostly due to insufficient reporting and singular measurements at baseline and follow-up. CONCLUSIONS Early-life lipid measurements are important for predicting adult levels. However, further research is needed to understand the tracking of non-high-density lipoprotein cholesterol and the stability of risk classification over time, which may further inform pediatric lipid screening and assessment strategies.
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Affiliation(s)
- Oliver Stanesby
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; Baker Heart and Diabetes Institute, Melbourne, Australia
| | | | - Petr Otahal
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - James P Goode
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Brooklyn J Fraser
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Kazuaki Negishi
- Sydney Medical School Nepean, Faculty of Medicine and Health, Charles Perkins Centre Nepean, The University of Sydney, Sydney, Australia; Nepean Hospital, Sydney, Australia
| | - Tetsuhiro Kidokoro
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia; Faculty of Sport Science, Nippon Sport Science University, Tokyo, Japan
| | - Tania Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland
| | - Feitong Wu
- Baker Heart and Diabetes Institute, Melbourne, Australia; Baker Department of Cardiometabolic Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Rebecca K Kelly
- School of Medicine, University of Tasmania, Hobart, Australia
| | - Bo Xi
- Department of Epidemiology, School of Public Health/Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jorma S A Viikari
- Department of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Stephen R Daniels
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Grant R Tomkinson
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Costan G Magnussen
- Baker Heart and Diabetes Institute, Melbourne, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
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de Oliveira AD, Dos Santos AR, de Oliveira LC, Nogueira Neto JF. The relevance of the optional use of fasting in laboratory measurements that make up the lipid profile: A systematic literature review. J Pharm Biomed Anal 2024; 240:115925. [PMID: 38154369 DOI: 10.1016/j.jpba.2023.115925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 10/28/2023] [Accepted: 12/13/2023] [Indexed: 12/30/2023]
Abstract
The objective of this study was to evaluate the impact of fasting easing on laboratory measurements of the lipid profile, in order to contribute to the fidelity of interpretation of laboratory results. Starting in October 2022, a Systematic Literature Review (SRL) was carried out, using articles indexed in the electronic databases PubMed/MEDLINE, EMBASE, Scopus, LILACS and Cochrane Library, following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes Group (PRISMA). This RSL was registered with PROSPERO, under registration number CRD42022370007. For inclusion, articles had to be original and developed in humans. After evaluating the methodological quality and analyzing the risk of bias, we obtained 16 articles published between 1994 and 2021, providing data on a total of 398,709 individuals, aged between 3 and 93 years. According to the selected studies, lipid profile measurements performed with flexible fasting, in addition to bringing benefits to patients and the pre-analytical system of the clinical laboratory, are more suitable for determining cardiovascular risk, mainly through the assessment of values obtained in the determination of triglycerides. It is therefore concluded that the optional use of fasting must be established through medical advice. In addition, laboratory methods and readings must be readjusted to this reality, informing through the report the parameters related to the lipid profile with and without the use of a 12-hour fast.
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Affiliation(s)
- Aliene Dias de Oliveira
- State University of Rio de Janeiro - UERJ, Lipid Laboratory, Piquet Carneiro Polyclinic, 381, Marechal Rondon Avenue, São Francisco Xavier, Rio de Janeiro, RJ 20950003, Brazil.
| | - Amanda Ribeiro Dos Santos
- State University of Rio de Janeiro - UERJ, Lipid Laboratory, Piquet Carneiro Polyclinic, 381, Marechal Rondon Avenue, São Francisco Xavier, Rio de Janeiro, RJ 20950003, Brazil
| | - Lívia Costa de Oliveira
- National Cancer Institute José Alencar Gomes da Silva - INCA, Palliative Care Unit, 274, Visconde de Santa Isabel Street, Vila Isabel, Rio de Janeiro, RJ 20560-121, Brazil
| | - José Firmino Nogueira Neto
- State University of Rio de Janeiro - UERJ, Lipid Laboratory, Piquet Carneiro Polyclinic, 381, Marechal Rondon Avenue, São Francisco Xavier, Rio de Janeiro, RJ 20950003, Brazil
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Liu J, Zhao L, Zhang Y, Wang L, Feng Q, Cui J, Zhang W, Zheng J, Wang D, Zhao F, He J, Chen Y. A higher non-HDL-C/HDL-C ratio was associated with an increased risk of progression of nonculprit coronary lesion in patients with acute coronary syndrome undergoing percutaneous coronary intervention. Clin Cardiol 2024; 47:e24243. [PMID: 38402557 PMCID: PMC10894525 DOI: 10.1002/clc.24243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 02/12/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND The ratio of nonhigh-density lipoprotein cholesterol (non-HDL-C) to high-density lipoprotein cholesterol (HDL-C) has been shown associated with various metabolic diseases and atherosclerosis in primary prevention. However, there is limited evidence on the relationship between the non-HDL-C/HDL-C ratio and progression of nonculprit coronary lesion (NCCL) after percutaneous coronary intervention (PCI). HYPOTHESIS Our study aimed to investigate the potential association between the non-HDL-C/HDL-C ratio and NCCL progression in patients with acute coronary syndrome (ACS) undergoing PCI. METHODS We conducted a retrospective analysis of ACS patients who underwent coronary angiography twice at a single center from 2016 to 2022. Lipid measurements, demographic, clinical, and other laboratory data were collected from electronic medical records. NCCLs were evaluated using quantitative coronary angiography. The primary outcome was the progression of NCCL. Patients were categorized based on NCCL progression and tertiles of the non-HDL-C/HDL-C ratio. Associations were analyzed using univariate and multivariate logistic regression analysis. RESULTS The study included 329 ACS patients who underwent PCI, with a median follow-up angiography of 1.09 years. We found NCCL progression in 95 (28.9%) patients with acceptable low-density lipoprotein cholesterol control (median: 1.81 mmol/L). Patients in the top tertile of the non-HDL-C/HDL-C ratio had a higher risk of NCCL progression. After adjusting for potential confounding factors, the non-HDL-C/HDL-C ratio remained a significant predictor for NCCL progression (adjusted odds ratio: 1.45; 95% confidence interval: 1.14-1.86; p < 0.05). CONCLUSIONS The non-HDL-C/HDL-C ratio predicts NCCL progression in ACS patients following PCI, providing a valuable tool for risk assessment and enhancing secondary prevention of atherosclerotic cardiovascular disease.
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Affiliation(s)
- Jiamin Liu
- The Second School of Clinical MedicineSouthern Medical UniversityGuangzhouChina
- Department of CardiologySixth Medical Center of PLA General HospitalBeijingChina
| | - Li Zhao
- Department of CardiologySixth Medical Center of PLA General HospitalBeijingChina
| | - Yazhou Zhang
- The Fourth Affiliated Hospital of Inner Mongolia Medical UniversityBaotouChina
- Fengning Manchu Autonomous County HospitalChengdeChina
| | - Lili Wang
- Department of CardiologySixth Medical Center of PLA General HospitalBeijingChina
| | - Qianqian Feng
- Department of CardiologySixth Medical Center of PLA General HospitalBeijingChina
| | - Jing Cui
- Department of CardiologySixth Medical Center of PLA General HospitalBeijingChina
| | - Wenhong Zhang
- Department of CardiologySixth Medical Center of PLA General HospitalBeijingChina
| | - Jianyong Zheng
- Department of CardiologySixth Medical Center of PLA General HospitalBeijingChina
| | - Dan Wang
- Department of CardiologySixth Medical Center of PLA General HospitalBeijingChina
| | - Fengjiao Zhao
- Department of CardiologySixth Medical Center of PLA General HospitalBeijingChina
| | - Jiangchun He
- Department of CardiologySixth Medical Center of PLA General HospitalBeijingChina
| | - Yu Chen
- The Second School of Clinical MedicineSouthern Medical UniversityGuangzhouChina
- Department of CardiologySixth Medical Center of PLA General HospitalBeijingChina
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Pogran E, Haller PM, Wegberger C, Tscharre M, Vujasin I, Kaufmann CC, Dick P, Jäger B, Wojta J, Huber K. The LIPL study: Postprandial lipid profile, inflammation, and platelet activity in patients with chronic coronary syndrome. ATHEROSCLEROSIS PLUS 2023; 54:14-21. [PMID: 37811126 PMCID: PMC10550804 DOI: 10.1016/j.athplu.2023.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/30/2023] [Accepted: 09/14/2023] [Indexed: 10/10/2023]
Abstract
Background and aims It is suggested that the changes in atherosclerosis happen mainly under the influence of non-fasting lipids. To date, the studies in the postprandial state were primarily performed on healthy subjects. This exploratory, cross-sectional study investigates the change in lipid profile, inflammation, and platelet activation in patients with different cardiovascular risk profiles in the postprandial state. Methods The studied population consists of 66 patients with different cardiovascular risks: patients with a history of the chronic coronary syndrome (CCS) and diabetes mellitus type 2 (DM2) (n = 20), CCS without DM2 (n = 25), and a healthy control group (n = 21). Lipid variables and markers of platelet function and inflammation were assessed during the fasting state and three and 5 h after a standardized fat meal using a standardized oral fat tolerance test (OFTT), a milkshake with 90 g of fat. Results Patients with CCS and DM2 were significantly older and had the highest BMI. All patients with CCS were on acetylsalicylic acid, and 95% of CCS patients were on high-dose statins. The absolute leukocyte and neutrophile count increased significantly in the control group during the OFTT in comparison to CCS subjects. There was a significant decrease of HDL and increase of triglycerides during the OFTT, however with no difference between groups. There was no difference in the change of platelet activity between all groups. Conclusion This study showed that OFTT leads to an increased postprandial inflammation response in healthy group compared to CCS ± DM2 while there was no change in lipid profile and platelet activity.
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Affiliation(s)
- Edita Pogran
- 3rd Medical Department for Cardiology and Intensive Care Medicine, Klinik Ottakring (Wilhelminenhospital), Vienna, Austria
- Sigmund Freud University, Medical Faculty, Vienna, Austria
| | - Paul M. Haller
- 3rd Medical Department for Cardiology and Intensive Care Medicine, Klinik Ottakring (Wilhelminenhospital), Vienna, Austria
- Ludwig Boltzmann Institute for Interventional Cardiology and Rhythmology, Austria
| | - Claudia Wegberger
- 3rd Medical Department for Cardiology and Intensive Care Medicine, Klinik Ottakring (Wilhelminenhospital), Vienna, Austria
| | - Maximilian Tscharre
- 3rd Medical Department for Cardiology and Intensive Care Medicine, Klinik Ottakring (Wilhelminenhospital), Vienna, Austria
| | - Irena Vujasin
- 3rd Medical Department for Cardiology and Intensive Care Medicine, Klinik Ottakring (Wilhelminenhospital), Vienna, Austria
| | - Christoph C. Kaufmann
- 3rd Medical Department for Cardiology and Intensive Care Medicine, Klinik Ottakring (Wilhelminenhospital), Vienna, Austria
- Sigmund Freud University, Medical Faculty, Vienna, Austria
| | - Petra Dick
- Klinik Ottakring, Department of Surgery with a Focus on Vascular Surgery- Vascular and Endovascular Surgery, Vienna, Austria
| | - Bernhard Jäger
- 3rd Medical Department for Cardiology and Intensive Care Medicine, Klinik Ottakring (Wilhelminenhospital), Vienna, Austria
- Ludwig Boltzmann Institute for Interventional Cardiology and Rhythmology, Austria
- Sigmund Freud University, Medical Faculty, Vienna, Austria
| | - Johann Wojta
- Ludwig Boltzmann Institute for Interventional Cardiology and Rhythmology, Austria
- Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
- Sigmund Freud University, Medical Faculty, Vienna, Austria
| | - Kurt Huber
- 3rd Medical Department for Cardiology and Intensive Care Medicine, Klinik Ottakring (Wilhelminenhospital), Vienna, Austria
- Ludwig Boltzmann Institute for Interventional Cardiology and Rhythmology, Austria
- Sigmund Freud University, Medical Faculty, Vienna, Austria
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De Luca L, Temporelli PL, Gulizia MM, Gonzini L, Ammaturo TA, Tedesco L, Pede S, Oliva F, Gabrielli D, Colivicchi F, Averna MR. Prevalence and predictive role of hypertriglyceridemia in statin-treated patients at very high risk: Insights from the START study. Nutr Metab Cardiovasc Dis 2023; 33:2398-2405. [PMID: 37788956 DOI: 10.1016/j.numecd.2023.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 07/20/2023] [Accepted: 07/26/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND AND AIM Elevated triglyceride (TG) levels seem to identify subjects at increased cardiovascular risk, independent of LDL-C levels. We sought to evaluate the predictive role of hypertriglyceridemia, defined as TG levels ≥150 mg/dl, in very high risk (VHR) patients with chronic coronary syndromes (CCS) treated with statins. METHODS AND RESULTS Using the data from the STable Coronary Artery Diseases RegisTry (START) study, an Italian nationwide registry, we assessed the association between the TG levels and baseline clinical characteristics, pharmacological treatment and major adverse cardio-cerebrovascular events (MACCE) at 1 year in a large cohort of statin-treated patients at VHR. Of the 4751 consecutive patients with CCS enrolled in the registry and classified as VHR, 2652 (55.8%) had TG values available (mean 120.6 ± 54.9) and were treated with at least a statin at baseline: 2019 (76.1%) with TG < 150 and 633 (23.9%) with TG ≥ 150 mg/dl. At 1 year from enrolment, MACCE occurred in 168 (6.3%) patients, without differences between the two groups of TG (5.9 vs 7.6%; p = 0.14). At multivariable analysis, hypertriglyceridemia did not result as independent predictor of the MACCE (hazard ratio: 1.16; 95% confidence intervals: 0.82-1.64; p = 0.42). CONCLUSIONS In the present large, nationwide cohort of consecutive CCS patients at VHR with statin-controlled LDL-C levels, hypertriglyceridemia was present in around 24% of cases and did not result as predictor of MACCE at 1 year. Further studies with a longer follow-up and larger sample size are needed to better define the prognostic role of TG levels when intensive LDL lowering therapies are used.
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Affiliation(s)
- Leonardo De Luca
- Department of of Cardio-Thoracic and Vascular Medicine and Surgery, Division of Cardiology, S. Camillo-Forlanini, Roma, Italy.
| | - Pier Luigi Temporelli
- Division of Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Gattico-Veruno, Novara, Italy
| | | | - Lucio Gonzini
- ANMCO Research Center, Heart Care Foundation, Firenze, Italy
| | | | - Luigi Tedesco
- Division of Cardiology, Ospedale Santa Maria della Speranza, Battipaglia SA, Italy
| | - Silvia Pede
- Division of Cardiology, Casa di Cura Petrucciani, Lecce, Italy
| | - Fabrizio Oliva
- Cardiovascular Department, Division of Cardiology, "A. De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Domenico Gabrielli
- Department of of Cardio-Thoracic and Vascular Medicine and Surgery, Division of Cardiology, S. Camillo-Forlanini, Roma, Italy; ANMCO Research Center, Heart Care Foundation, Firenze, Italy
| | | | - Maurizio R Averna
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), Università degli Studi di Palermo, Palermo, Italy; Istituto di Biofisica, Consiglio Nazionale delle Ricerche, Palermo, Italy
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Zhang J, Tang Z, Jiang J, Huang S, Zeng H, Gu J, Wang C, Zhang H. Clinical and Prognostic Value of Non-Fasting Lipoproteins and Apolipoproteins in Chinese Patients with Coronary Heart Disease. Rev Cardiovasc Med 2023; 24:314. [PMID: 39076452 PMCID: PMC11272848 DOI: 10.31083/j.rcm2411314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 05/10/2023] [Accepted: 05/17/2023] [Indexed: 07/31/2024] Open
Abstract
Background Lipid profiles differ naturally between individuals and between populations. So far, the data relating to non-fasting lipid profiles has been derived predominantly from studies on Western population. The characteristics and clinical significance of non-fasting lipids in Chinese patients with coronary heart disease (CHD) in response to traditional Chinese diets remain poorly understood. Methods A total of 1022 Chinese CHD patients with coronary artery luminal stenosis > 40% as diagnosed by coronary artery angiography were enrolled in the study. All patients received standard treatment for CHD, including statins. They were divided into an intermediate stenosis group (luminal stenosis 40-70%, n = 486) or a severe stenosis group (luminal stenosis > 70%, n = 536). Their blood lipid profiles were measured in the fasting state, and 4 hours after normal breakfast. All participants were followed up for five years. Major adverse cardiovascular events (MACE) including all-cause death, cardiac death, myocardial infarction, unscheduled coronary revascularization and stroke were recorded. Results After normal breakfast intake, patients with intermediate or severe stenosis showed an apparent increase in the levels of triglyceride (TG), remnant cholesterol (RC) and Apo (apolipoprotein) A1 compared to the fasting state, but a significant reduction in the levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), Apo B and Apo E. In addition to the traditional risk factors (older age, male, diabetes and smoking) and coronary artery stenosis, the fasting levels of LDL-C and Apo B, as well as non-fasting levels of HDL-C and Apo A1, were identified as independent predictors of 5-year MACE occurrence by multivariate Cox proportional hazards analysis. Patients in the 1st tertile of the non-fasting HDL-C group ( < 0.86 mmol/L) showed a significantly higher risk of MACE than 3rd tertile ( > 1.07 mmol/L) (1st tertile: 2.786, 95% CI (confidence intervals) [1.808, 4.293], p < 0.001). Conclusions This prospective observational study found that lipid profiles in either the fasting or non-fasting states were associated with the long-term risk of MACE in Chinese CHD patients. In addition to the fasting LDL-C level, a low non-fasting HDL-C level may also be an independent risk factors for cardiovascular events. Measurement of lipid profiles during the non-fasting state may be feasible for the management of CHD patients in routine clinical practice in China.
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Affiliation(s)
- Junfeng Zhang
- Department of Cardiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 200011 Shanghai, China
| | - Zhengde Tang
- Department of Cardiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 200011 Shanghai, China
| | - Jintong Jiang
- Department of Cardiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 200011 Shanghai, China
| | - Shuying Huang
- Department of Cardiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 200011 Shanghai, China
| | - Huasu Zeng
- Department of Cardiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 200011 Shanghai, China
| | - Jun Gu
- Department of Cardiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 200011 Shanghai, China
| | - Changqian Wang
- Department of Cardiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 200011 Shanghai, China
| | - Huili Zhang
- Department of Cardiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 200011 Shanghai, China
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Astarita G, Kelly RS, Lasky-Su J. Metabolomics and lipidomics strategies in modern drug discovery and development. Drug Discov Today 2023; 28:103751. [PMID: 37640150 PMCID: PMC10543515 DOI: 10.1016/j.drudis.2023.103751] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/09/2023] [Accepted: 08/21/2023] [Indexed: 08/31/2023]
Abstract
Metabolomics and lipidomics have an increasingly pivotal role in drug discovery and development. In the context of drug discovery, monitoring changes in the levels or composition of metabolites and lipids relative to genetic variations yields functional insights, bolstering human genetics and (meta)genomic methodologies. This approach also sheds light on potential novel targets for therapeutic intervention. In the context of drug development, metabolite and lipid biomarkers contribute to enhanced success rates, promising a transformative impact on precision medicine. In this review, we deviate from analytical chemist-focused perspectives, offering an overview tailored to drug discovery. We provide introductory insight into state-of-the-art mass spectrometry (MS)-based metabolomics and lipidomics techniques utilized in drug discovery and development, drawing from the collective expertise of our research teams. We comprehensively outline the application of metabolomics and lipidomics in advancing drug discovery and development, spanning fundamental research, target identification, mechanisms of action, and the exploration of biomarkers.
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Affiliation(s)
- Giuseppe Astarita
- Georgetown University, Washington, DC, USA; Arkuda Therapeutics, Watertown, MA, USA.
| | - Rachel S Kelly
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jessica Lasky-Su
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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10
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Johansen MØ, Moreno-Vedia J, Balling M, Davey Smith G, Nordestgaard BG. Triglyceride content increases while cholesterol content decreases in HDL and LDL+IDL fractions following normal meals: The Copenhagen General Population Study of 25,656 individuals. Atherosclerosis 2023; 383:117316. [PMID: 37820443 PMCID: PMC7615473 DOI: 10.1016/j.atherosclerosis.2023.117316] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 09/22/2023] [Accepted: 09/26/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND AND AIMS During fat tolerance tests, plasma triglycerides increase while high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and intermediate-density lipoprotein (IDL) cholesterol decrease. However, it is unknown whether triglyceride content increases and cholesterol content decreases in HDL and LDL + IDL fractions following normal meals in the general population. Therefore, we tested the hypothesis that triglyceride content increases while cholesterol content decreases in HDL and LDL + IDL fractions following normal meals. METHODS In this cross-sectional study, we included 25,656 individuals aged 20-100 years, all without lipid-lowering therapy at examination and selected for metabolomic profiling from the Copenhagen General Population Study. Triglyceride and cholesterol content of 14 lipoprotein fractions weas measured using nuclear magnetic resonance (NMR) spectroscopy. Time since last meal was recorded by the examiner immediately before blood sampling. RESULTS Following normal meals in age and sex-adjusted analyses and when compared with fasting levels, plasma triglycerides were higher for up to 5-6 h, and triglyceride content was higher for up to 6-7 h in HDL fractions, for up to 6-7 h in LDL + IDL fractions, and for up to 5-6 h in very-low-density lipoprotein (VLDL) fractions. Further, plasma cholesterol was lower for up to 2-3 h, and cholesterol content was lower for up to 0-1 h in HDL fractions and for up to 4-5 h in LDL + IDL fractions, while cholesterol content was higher for up to 4-5 h in VLDL fractions. CONCLUSIONS Following normal meals, triglyceride content increases while cholesterol content decreases in HDL and LDL + IDL fractions.
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Affiliation(s)
- Mia Ø Johansen
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark; The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Juan Moreno-Vedia
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark; Vascular Medicine and Metabolism Unit, Research Unit on Lipids and Atherosclerosis, Sant Joan University Hospital, Universitat Rovira i Virgili, Reus, Spain; Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain
| | - Mie Balling
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark; The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - George Davey Smith
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, United Kingdom; Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark; The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
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11
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Jabbar HK, Hassan MK, Al-Naama LM. Lipids profile in children and adolescents with β-thalassemia major. Hematol Transfus Cell Ther 2023; 45:467-472. [PMID: 36379885 PMCID: PMC10627856 DOI: 10.1016/j.htct.2022.09.1277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/05/2022] [Accepted: 09/08/2022] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Patients with β-thalassemia major (β-TM) are at risk of developing abnormal lipid profiles. Lipid abnormalities, in turn, have a potential role in the pathogenesis of some clinical aspects of thalassemia OBJECTIVES: To evaluate lipid levels and atherogenic indices in β-TM patients compared to healthy children and for any association between lipid levels, lipid peroxidation and inflammatory biomarkers METHODS: This case-control study was carried out on 79 patients with β-TM, aged 6 to 16 years, registered at the Basrah Center for Hereditary Blood Diseases and 85 age- and sex-matched apparently healthy children and adolescents. Complete blood count, serum lipids and ferritin, liver function tests, C-reactive protein (CRP), high-sensitivity CRP (hs-CRP) and serum malondialdehyde (MDA) were evaluated RESULTS: Patients with β-TM had significantly lower hemoglobin (Hb), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL) and non-high-density lipoprotein (non-HDL) and significantly higher very low-density lipoprotein (VLDL), triglycerides (TGs), LDL/HDL ratio, MDA, hs-CRP, total serum bilirubin (TSB), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) than the control group (p < 0.05). A bivariate analysis revealed that TC has a significant positive association with Hb. The TG has a significant negative association with Hb and a positive association with serum ferritin. Furthermore, MDA, TG, TSB, ALT and AST were significantly positively correlated with serum ferritin (p < 0.05) CONCLUSIONS: Atherogenic dyslipidemia, defined as a high low-density lipoprotein cholesterol (LDL-C/high-density lipoprotein cholesterol (HDL-C) ratio and high TG level, is common among pediatric β-TM patients, it is associated with iron overload and places patients at an increased cardiovascular risk.
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12
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Arrobas Velilla T, Guijarro C, Campuzano Ruiz R, Rodríguez Piñero M, Valderrama Marcos JF, Pérez Pérez A, Botana López MA, Morais López A, García Donaire JA, Carlos Obaya J, Castilla Guerra L, Pallares Carratalá V, Egocheaga Cabello I, Salgueira Lazo M, Castellanos Rodrigo MM, Mostaza Prieto JM, Gómez Doblas JJ, Buño Soto A. Consensus document for lipid profile testing and reporting in Spanish clinical laboratories: What parameters should a basic lipid profile include? Rev Clin Esp 2023; 223:440-449. [PMID: 37302464 DOI: 10.1016/j.rceng.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 06/13/2023]
Abstract
Cardiovascular diseases (CVD) continue to be the main cause of death in our country. Adequate control of lipid metabolism disorders is a key challenge in cardiovascular prevention that is far from being achieved in real clinical practice. There is a great heterogeneity in the reports of lipid metabolism from Spanish clinical laboratories, which may contribute to its poor control. For this reason, a working group of the main scientific societies involved in the care of patients at vascular risk, has prepared this document with a consensus proposal on the determination of the basic lipid profile in cardiovascular prevention, recommendations for its realization and unification of criteria to incorporate the lipid control goals appropriate to the vascular risk of the patients in the laboratory reports.
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Affiliation(s)
- Teresa Arrobas Velilla
- Sociedad Española de Medicinade Laboratorio (SEQCML), Laboratoriode Bioquímica Clínica, Hospital Universitario Virgen Macarena de Sevilla, Sevilla, Spain. Investigador Asociado, Facultad de Cienciasdela Salud, Universidad Autónomade Chile, Santiago de Chile, Chile
| | - Carlos Guijarro
- Sociedad Española de Arteriosclerosis (SEA), Unidadde Medicina Interna, Hospital Universitario Fundaciónde Alcorcón, Universidad Rey Juan Carlos, Madrid, Spain.
| | - Raquel Campuzano Ruiz
- Sociedad Española de Cardiología (SEC), Unidadde Cardiología, Hospital Universitario Fundaciónde Alcorcón, Asociaciónde Riesgo vasculary Rehabilitación Cardiacadela Sociedad Española de Cardiología, Madrid, Spain
| | - Manuel Rodríguez Piñero
- Sociedad Española de Angiologíay CirugíaVascular (SEACV), Unidad Intercentros Cádiz-Jerezde Angiologíay Cirugía Vascular, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - José Francisco Valderrama Marcos
- Sociedad Española de Cirugía Cardiovasculary Endovascular (SECCE), Cirugía Cardiovascular, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Antonio Pérez Pérez
- Sociedad Española de Diabetes (SED), Serviciode Endocrinologíay Nutrición, Hospital de la Santa Creui Sant Pau, Barcelona, Spain
| | - Manuel Antonio Botana López
- Sociedad Española de Endocrinologíay Nutrición (SEEN), Secciónde Endocrinología, Hospital Universitario Lucus Augusti, Lugo, Spain
| | - Ana Morais López
- Sociedad Española de Gastroenterología, Hepatologíay Nutrición Pediátrica (SEGHNP), Unidad de Nutrición Infantily Enfermedades Metabólicas, Hospital Universitario La Paz, Madrid, Spain
| | - José Antonio García Donaire
- Sociedad Española de Hipertensión, Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA), Unidad de Hipertensión Arterial, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Juan Carlos Obaya
- Sociedad Española de Medicinade Familiay Comunitaria (SEMFyC), Medicina Familiary Comunitaria, CS La Chopera, Alcobendas, Madrid, Spain
| | - Luis Castilla Guerra
- Sociedad Española de MedicinaInterna (SEMI), Unidad de Hipertensión, Lípidosy Riesgo Vascular, Servicio de Medicina Interna, Hospital Virgen Macarena, PCDV Departamento de Medicina, Universidad de Sevilla, Sevilla, Spain
| | - Vicente Pallares Carratalá
- Sociedad Española de Médicos de Atención Primaria (SEMERGEN), Unidad de Vigilancia de la Salud, Uniónde Mutuas, Departamento de Medicina, Universitat Jaume I, Castellón, Castellón, Spain
| | - Isabel Egocheaga Cabello
- Sociedad Española de Médicos Generales y de Familia (SEMG), Medicina Familiar y Comunitaria, Centro de Salud Islade Oza, Servicio Madrileño de Salud, Madrid, Spain
| | - Mercedes Salgueira Lazo
- Sociedad Española de Nefrología (SEN), Unidad de Nefrología, Hospital Universitario Virgen Macarena de Sevilla, Sevilla, Spain
| | - María Mar Castellanos Rodrigo
- Sociedad Española de Neurología (SEN), Servicio de Neurología Complejo Hospitalario Universitario A Coruña/Instituto de Investigación Biomédica A Coruña, A Coruña, Spain
| | - José María Mostaza Prieto
- Sociedad Española de Arteriosclerosis (SEA), Servicio de Medicina Interna, Hospital La Paz-Carlos III, Madrid, Spain
| | - Juan José Gómez Doblas
- Sociedad Española de Cardiología (SEC), Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Antonio Buño Soto
- Sociedad Española de Medicina de Laboratorio (SEQCML), Servicio de Análisis Clínicos, Hospital Universitario La Paz, Madrid, Spain
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13
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Arrobas Velilla T, Guijarro C, Campuzano Ruiz R, Rodríguez Piñero M, Valderrama Marcos JF, Botana López AM, Morais López A, García Donaire JA, Obaya JC, Castilla Guerra L, Pallares Carratalá V, Egocheaga Cabello I, Salgueira Lazo M, Castellanos Rodrigo MM, Mostaza Prieto JM, Gómez Doblas JJ, Buño Soto A. Consensus document for lipid profile testing and reporting in Spanish clinical laboratories. ENDOCRINOL DIAB NUTR 2023; 70:501-510. [PMID: 37268528 DOI: 10.1016/j.endien.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 06/04/2023]
Abstract
Cardiovascular diseases (CVD) continue to be the main cause of death in our country. Adequate control of lipid metabolism disorders is a key challenge in cardiovascular prevention that is far from being achieved in real clinical practice. There is a great heterogeneity in the reports of lipid metabolism from Spanish clinical laboratories, which may contribute to its poor control. For this reason, a working group of the main scientific societies involved in the care of patients at vascular risk, has prepared this document with a consensus proposal on the determination of the basic lipid profile in cardiovascular prevention, recommendations for its realization and unification of criteria to incorporate the lipid control goals appropriate to the vascular risk of the patients in the laboratory reports.
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Affiliation(s)
- Teresa Arrobas Velilla
- Spanish Society of Laboratory Medicine (SEQCML), Laboratory of Clinical Biochemistry, Virgen Macarena University Hospital, Seville, Spain
| | - Carlos Guijarro
- Spanish Society of Arteriosclerosis (SEA), Unit of Internal Medicine, Hospital Alcorcón Foundation University Hospital, Rey Juan Carlos University, Madrid, Spain.
| | - Raquel Campuzano Ruiz
- Spanish Society of Cardiology (SEC), Unit of Cardiology, Alcorcón Foundation University Hospital, Association for Vascular Risk and Cardiac Rehabilitation of the Spanish Society of Cardiology, Madrid, Spain
| | - Manuel Rodríguez Piñero
- Spanish Society of Angiology and Vascular Surgery (SEACV), Cross-center Cádiz-Jerez Unit of Angiology and Vascular Surgery, Puerta del Mar University Hospital, Cádiz, Spain
| | - José Francisco Valderrama Marcos
- Spanish Society of Cardiovascular and Endovascular Surgery, Cardiovascular Surgery (SECCE), Regional University Hospital of Malaga, Málaga, Spain
| | - Antonio M Botana López
- Spanish Society of Endocrinology and Nutrition (SEEN), Section of Endocrinology, Lucus Augusti University Hospital, Lugo, Spain
| | - Ana Morais López
- Spanish Society of Gastroenterology, Paediatric Hepatology and Nutrition (SEGHNP), Unit of Paediatric Nutrition and Metabolic Diseases, La Paz University Hospital, Madrid, Spain
| | - José Antonio García Donaire
- Spanish Society of Hypertension, Spanish League for the Fight Against Arterial Hypertension (SEH-LELHA), Unit of Arterial Hypertension, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Juan Carlos Obaya
- Spanish Society of Family and Community Family (SEMFyC), CS La Chopera, Alcobendas, Madrid, Spain
| | - Luis Castilla Guerra
- Spanish Society of Internal Medicine (SEMI), Unit of Hypertension, Lipids and Vascular Risk, Service of Internal Medicine, Spain
| | - Vicente Pallares Carratalá
- Hospital Virgen Macarena, PCDV Departamento de Medicina, University of Seville, Spanish Society of Primary Care Physicians (SEMERGEN), Unit of Health Surveillance, Unión de Mutuas, Department of Medicine, Universitat Jaume I, Castellón, Castellón, Spain
| | - Isabel Egocheaga Cabello
- Spanish Society of General and Family Doctors (SEMG), Family and Community Medicine, Centro de Salud Isla de Oza, Servicio Madrileño de Salud, Madrid, Spain
| | - Mercedes Salgueira Lazo
- Spanish Society of Nephrology (SEN), Unit of Nephrology, Virgen Macarena University Hospital, Seville, Spain
| | - María Mar Castellanos Rodrigo
- Spanish Society of Neurology (SEN), Service of Neurology, Complejo Hospitalario Universitario A Coruña/Instituto de Investigación Biomédica A Coruña, Coruña, Spain
| | - José María Mostaza Prieto
- Spanish Society of Arteriosclerosis (SEA), Service of Internal Medicine, Hospital La Paz-Carlos III, Madrid, Spain
| | - Juan José Gómez Doblas
- Spanish Society of Cardiology (SEC), Service of Cardiology, Virgen de la Victoria University Hospital, Málaga, Spain
| | - Antonio Buño Soto
- Spanish Society of Laboratory Medicine (SEQCML), Service of Clinical Biochemistry, La Paz University Hospital, Madrid, Spain
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14
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Velilla TA, Guijarro C, Ruiz RC, Piñero MR, Francisco Valderrama Marcos J, López AMB, López AM, Antonio García Donaire J, Obaya JC, Castilla Guerra L, Carratalá VP, Cabello IE, Lazo MS, Rodrigo MMC, María Mostaza Prieto J, Doblas JJG, Soto AB. Consensus document for lipid profile determination and reporting in Spanish clinical laboratories. What parameters should be included in a basic lipid profile? Nefrologia 2023; 43:474-483. [PMID: 37813740 DOI: 10.1016/j.nefroe.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 10/11/2023] Open
Abstract
Cardiovascular diseases (CVD) continue to be the main cause of death in our country. Adequate control of lipid metabolism disorders is a key challenge in cardiovascular prevention that is far from being achieved in real clinical practice. There is a great heterogeneity in the reports of lipid metabolism from Spanish clinical laboratories, which may contribute to its poor control. For this reason, a working group of the main scientific societies involved in the care of patients at vascular risk, has prepared this document with a consensus proposal on the determination of the basic lipid profile in cardiovascular prevention, recommendations for its realization and unification of criteria to incorporate the lipid control goals appropriate to the vascular risk of the patients in the laboratory reports.
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Affiliation(s)
- Teresa Arrobas Velilla
- Spanish Society of Laboratory Medicine (SEQCML), Laboratory of Clinical Biochemistry, Virgen Macarena University Hospital, Seville, Spain
| | - Carlos Guijarro
- Spanish Society of Arteriosclerosis (SEA), Unit of Internal Medicine, Hospital Alcorcón Foundation University Hospital, Rey Juan Carlos University, Madrid, Spain.
| | - Raquel Campuzano Ruiz
- Spanish Society of Cardiology (SEC), Unit of Cardiology, Alcorcón Foundation University Hospital, Association for Vascular Risk and Cardiac Rehabilitation of the Spanish Society of Cardiology, Madrid, Spain
| | - Manuel Rodríguez Piñero
- Spanish Society of Angiology and Vascular Surgery (SEACV), Cross-center Cádiz-Jerez Unit of Angiology and Vascular Surgery, Puerta del Mar University Hospital, Cádiz, Spain
| | - José Francisco Valderrama Marcos
- Spanish Society of Cardiovascular and Endovascular Surgery, Cardiovascular Surgery (SECCE), Regional University Hospital of Malaga, Málaga, Spain
| | - Antonio M Botana López
- Spanish Society of Endocrinology and Nutrition (SEEN), Section of Endocrinology, Lucus Augusti University Hospital, Lugo, Spain
| | - Ana Morais López
- Spanish Society of Gastroenterology, Paediatric Hepatology and Nutrition (SEGHNP), Unit of Paediatric Nutrition and Metabolic Diseases, La Paz University Hospital, Madrid, Spain
| | - José Antonio García Donaire
- Spanish Society of Hypertension, Spanish League for the Fight Against Arterial Hypertension (SEH-LELHA), Unit of Arterial Hypertension, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Juan Carlos Obaya
- Spanish Society of Family and Community Family (SEMFyC), CS La Chopera, Alcobendas, Madrid, Spain
| | - Luis Castilla Guerra
- Spanish Society of Internal Medicine (SEMI), Unit of Hypertension, Lipids and Vascular Risk, Service of Internal Medicine, Spain
| | - Vicente Pallares Carratalá
- Hospital Virgen Macarena, PCDV Departamento de Medicina, University of Seville, Sevilla, Spain, Spanish Society of Primary Care Physicians (SEMERGEN), Unit of Health Surveillance, Unión de Mutuas, Department of Medicine, Universitat Jaume I, Castellón, Castellón, Spain
| | - Isabel Egocheaga Cabello
- Spanish Society of General and Family Doctors (SEMG), Family and Community Medicine, Centro de Salud Isla de Oza, Servicio Madrileño de Salud, Madrid, Spain
| | - Mercedes Salgueira Lazo
- Spanish Society of Nephrology (SEN), Unit of Nephrology, Virgen Macarena University Hospital, Seville, Spain
| | - María Mar Castellanos Rodrigo
- Spanish Society of Neurology (SEN), Service of Neurology, Complejo Hospitalario Universitario A Coruña/Instituto de Investigación Biomédica A Coruña, Coruña, Spain
| | - José María Mostaza Prieto
- Spanish Society of Arteriosclerosis (SEA), Service of Internal Medicine, Hospital La Paz-Carlos III, Madrid, Spain
| | - Juan José Gómez Doblas
- Spanish Society of Cardiology (SEC), Service of Cardiology, Virgen de la Victoria University Hospital, Málaga, Spain q Spanish Society of Laboratory Medicine (SEQCML), Service of Clinical Biochemistry, La Paz University Hospital, Madrid, Spain
| | - Antonio Buño Soto
- Spanish Society of Cardiology (SEC), Service of Cardiology, Virgen de la Victoria University Hospital, Málaga, Spain q Spanish Society of Laboratory Medicine (SEQCML), Service of Clinical Biochemistry, La Paz University Hospital, Madrid, Spain
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15
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Al Mousa E, Al-Azzam S, Araydah M, Karasneh R, Ghnaimat M, Al-Makhamreh H, Al Khawaldeh A, Ali Abu Al-Samen M, Haddad J, Al Najjar S, Alsalaheen Abbadi H, Hammoudeh AJ. A Jordanian Multidisciplinary Consensus Statement on the Management of Dyslipidemia. J Clin Med 2023; 12:4312. [PMID: 37445345 DOI: 10.3390/jcm12134312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/12/2023] [Accepted: 06/25/2023] [Indexed: 07/15/2023] Open
Abstract
Atherosclerotic cardiovascular disease (ASCVD) is the primary contributor to global mortality rates, which significantly escalates healthcare expenditures. Risk factors for ASCVD (including dyslipidemia) frequently present in clusters rather than separately. Addressing these risk factors is crucial in the early initiation of a comprehensive management plan that involves both lifestyle modifications and pharmacotherapy to reduce the impact of ASCVD. A team of Jordanian professionals from various medical organizations and institutes took the initiative to create a set of guidelines for dyslipidemia screening and therapy. A detailed, comprehensive literature review was undertaken utilizing several databases and keywords. This consensus statement provides recommendations for dyslipidemia management in Jordanians on several issues including cardiovascular risk estimation, screening eligibility, risk categories, treatment goals, lifestyle changes, and statin and non-statin therapies. It is recommended that all Jordanian individuals aged 20 years old or older undergo lipid profile testing. This should be followed by determining the level of cardiovascular risk depending on the presence or absence of ASCVD and cardiovascular risk factors, eligibility for lipid-lowering therapy, and the target low-density cholesterol serum level to be achieved. In conclusion, prioritizing the management of dyslipidemia is of the utmost importance in improving public health and reducing the burden of cardiovascular diseases.
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Affiliation(s)
- Eyas Al Mousa
- Jordanian Atherosclerosis and Hypertension Society, Amman 11942, Jordan
| | - Sayer Al-Azzam
- Clinical Pharmacy Department, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan
| | | | - Reema Karasneh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid 21163, Jordan
| | - Mohammad Ghnaimat
- Jordan Society of Internal Medicine, Amman 11942, Jordan
- Jordan Society of Nephrology, Amman 11942, Jordan
| | - Hanna Al-Makhamreh
- Cardiology Division, School of Medicine, University of Jordan, Amman 11942, Jordan
| | | | | | - Jihad Haddad
- Scientific Committee, Jordanian Atherosclerosis and Hypertension Society, Amman 11942, Jordan
| | - Said Al Najjar
- Cardiology Department at Albasheer Hospital (MOH), Amman 11942, Jordan
| | | | - Ayman J Hammoudeh
- Scientific Committee, Cardiovascular Academy Group of the Jordan Cardiac Society, Amman 11942, Jordan
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16
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Arrobas Velilla T, Guijarro C, Ruiz RC, Piñero MR, Valderrama Marcos JF, Pérez Pérez A, Botana López AM, López AM, García Donaire JA, Obaya JC, Castilla-Guerra L, Carratalá VP, Cabello IE, Lazo MS, Castellanos Rodrigo MM, Mostaza Prieto JM, Gómez Doblas JJ, Buño Soto A. Consensus document for lipid profile testing and reporting in Spanish clinical laboratories: what parameters should a basic lipid profile include? ADVANCES IN LABORATORY MEDICINE 2023; 4:138-156. [PMID: 38075943 PMCID: PMC10701497 DOI: 10.1515/almed-2023-0047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/02/2023] [Indexed: 04/05/2024]
Abstract
Cardiovascular diseases (CVD) continue to be the main cause of death in our country. Adequate control of lipid metabolism disorders is a key challenge in cardiovascular prevention that is far from being achieved in real clinical practice. There is a great heterogeneity in the reports of lipid metabolism from Spanish clinical laboratories, which may contribute to its poor control. For this reason, a working group of the main scientific societies involved in the care of patients at vascular risk, has prepared this document with a consensus proposal on the determination of the basic lipid profile in cardiovascular prevention, recommendations for its realization and unification of criteria to incorporate the lipid control goals appropriate to the vascular risk of the patients in the laboratory reports.
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Affiliation(s)
- Teresa Arrobas Velilla
- Spanish Society of Laboratory Medicine (SEQCML), Laboratory of Clinical Biochemistry, Virgen Macarena University Hospital, Seville, Spain
| | - Carlos Guijarro
- Spanish Society of Arteriosclerosis (SEA), Unit of Internal Medicine, Hospital Alcorcón Foundation University Hospital, Rey Juan Carlos University, Madrid, Spain
| | - Raquel Campuzano Ruiz
- Spanish Society of Cardiology (SEC), Unit of Cardiology, Alcorcón Foundation University Hospital, Association for Vascular Risk and Cardiac Rehabilitation of the Spanish Society of Cardiology, Madrid, Spain
| | - Manuel Rodríguez Piñero
- Spanish Society of Angiology and Vascular Surgery (SEACV), Cross-center Cádiz-Jerez Unit of Angiology and Vascular Surgery, Puerta del Mar University Hospital, Cádiz, Spain
| | - José Francisco Valderrama Marcos
- Spanish Society of Cardiovascular and Endovascular Surgery, Cardiovascular Surgery (SECCE), Regional University Hospital of Malaga, Málaga, Spain
| | - Antonio Pérez Pérez
- Spanish Society of Diabetes (SED), Endocrinology and Nutrition Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Antonio M Botana López
- Spanish Society of Endocrinology and Nutrition (SEEN), Section of Endocrinology, Lucus Augusti University Hospital, Lugo, Spain
| | - Ana Morais López
- Spanish Society of Gastroenterology, Paediatric Hepatology and Nutrition (SEGHNP), Unit of Paediatric Nutrition and Metabolic Diseases, La Paz University Hospital, Madrid, Spain
| | - José Antonio García Donaire
- Spanish Society of Hypertension, Spanish League for the Fight Against Arterial Hypertension (SEH-LELHA), Unit of Arterial Hypertension, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Juan Carlos Obaya
- Spanish Society of Family and Community Family (SEMFyC), CS La Chopera, Alcobendas, Madrid, Spain
| | - Luis Castilla-Guerra
- Spanish Society of Internal Medicine (SEMI), Unit of Hypertension, Lipids and Vascular Risk, Service of Internal Medicine, Seville, Spain
| | - Vicente Pallares Carratalá
- Hospital Virgen Macarena, PCDV Departamento de Medicina, University of Seville, Sevilla, Spain
- Spanish Society of Primary Care Physicians (SEMERGEN), Unit of Health Surveillance, Unión de Mutuas, Department of Medicine, Universitat Jaume I, Castellón, Castellón, Spain
| | - Isabel Egocheaga Cabello
- Spanish Society of General and Family Doctors (SEMG), Family and Community Medicine, Centro de Salud Isla de Oza, Servicio Madrileño de Salud, Madrid, Spain
| | - Mercedes Salgueira Lazo
- Spanish Society of Nephrology (SEN), Unit of Nephrology, Virgen Macarena University Hospital, Seville, Spain
| | - María Mar Castellanos Rodrigo
- Spanish Society of Neurology (SEN), Service of Neurology, Complejo Hospitalario Universitario A Coruña/Instituto de Investigación Biomédica A Coruña, Coruña, Spain
| | - José María Mostaza Prieto
- Spanish Society of Arteriosclerosis (SEA), Service of Internal Medicine, Hospital La Paz-Carlos III, Madrid, Spain
| | - Juan José Gómez Doblas
- Spanish Society of Cardiology (SEC), Service of Cardiology, Virgen de la Victoria University Hospital, Málaga, Spain
| | - Antonio Buño Soto
- Spanish Society of Laboratory Medicine (SEQCML), Service of Clinical Biochemistry, La Paz University Hospital, Madrid, Spain
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Arrobas Velilla T, Guijarro C, Campuzano Ruiz R, Rodríguez Piñero M, Valderrama Marcos JF, Pérez Pérez A, Botana López MA, Morais López A, García Donaire JA, Obaya JC, Castilla Guerra L, Pallares Carratalá V, Egocheaga Cabello I, Salgueira Lazo M, Castellanos Rodrigo MM, Mostaza Prieto JM, Gómez Doblas JJ, Buño Soto A. [Consensus document for lipid profile determination and reporting in Spanish clinical laboratories]. HIPERTENSION Y RIESGO VASCULAR 2023; 40:75-84. [PMID: 37121876 PMCID: PMC10176999 DOI: 10.1016/j.hipert.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 12/15/2022] [Indexed: 05/02/2023]
Abstract
Cardiovascular diseases (CVD) continue to be the main cause of death in our country. Adequate control of lipid metabolism disorders is a key challenge in cardiovascular prevention that is far from being achieved in real clinical practice. There is a great heterogeneity in the reports of lipid metabolism from Spanish clinical laboratories, which may contribute to its poor control. For this reason, a working group of the main scientific societies involved in the care of patients at vascular risk, has prepared this document with a consensus proposal on the determination of the basic lipid profile in cardiovascular prevention, recommendations for its realization and unification of criteria to incorporate the lipid control goals appropriate to the vascular risk of the patients in the laboratory reports.
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Affiliation(s)
- Teresa Arrobas Velilla
- Sociedad Española de Medicina de Laboratorio (SEQCML), Laboratorio de Bioquímica Clínica, Hospital Universitario Virgen Macarena de Sevilla, Sevilla, España. Investigador Asociado, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago de Chile, Chile
| | - Carlos Guijarro
- Sociedad Española de Arteriosclerosis (SEA), Unidad de Medicina Interna, Hospital Universitario Fundación de Alcorcón, Universidad Rey Juan Carlos, Madrid, España.
| | - Raquel Campuzano Ruiz
- Sociedad Española de Cardiología (SEC), Unidad de Cardiología, Hospital Universitario Fundación de Alcorcón, Asociación de Riesgo vascular y Rehabilitación Cardiaca de la Sociedad Española de Cardiología, Madrid, España
| | - Manuel Rodríguez Piñero
- Sociedad Española de Angiología y Cirugía Vascular (SEACV), Unidad Intercentros Cádiz-Jerez de Angiología y Cirugía Vascular, Hospital Universitario Puerta del Mar, Cádiz, España
| | - José Francisco Valderrama Marcos
- Sociedad Española de Cirugía Cardiovascular y Endovascular, (SECCE), Cirugía Cardiovascular, Hospital Regional Universitario de Málaga, Málaga, España
| | - Antonio Pérez Pérez
- Sociedad Española de Diabetes (SED), Servicio de Endocrinología y Nutrición, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - Manuel Antonio Botana López
- Sociedad Española de Endocrinología y Nutrición (SEEN), Sección de Endocrinología, Hospital Universitario Lucus Augusti, Lugo, España
| | - Ana Morais López
- Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica (SEGHNP), Unidad de Nutrición Infantil y Enfermedades Metabólicas, Hospital Universitario La Paz, Madrid, España
| | - José Antonio García Donaire
- Sociedad Española de Hipertensión, Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA), Unidad de Hipertensión Arterial, Hospital Clínico Universitario San Carlos, Madrid, España
| | - Juan Carlos Obaya
- Sociedad Española de Medicina de Familia y Comunitaria (SEMFyC), Medicina Familiar y Comunitaria, CS La Chopera, Alcobendas, Madrid, España
| | - Luis Castilla Guerra
- Sociedad Española de Medicina Interna (SEMI), Unidad de Hipertensión, Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital Virgen Macarena, PCDV Departamento de Medicina, Universidad de Sevilla, Sevilla, España
| | - Vicente Pallares Carratalá
- Sociedad Española de Médicos de Atención Primaria (SEMERGEN), Unidad de Vigilancia de la Salud, Unión de Mutuas, Departamento de Medicina, Universitat Jaume I, Castellón, Castellón, España
| | - Isabel Egocheaga Cabello
- Sociedad Española de Médicos Generales y de Familia (SEMG), Medicina Familiar y Comunitaria, Centro de Salud Isla de Oza, Servicio Madrileño de Salud, Madrid, España
| | - Mercedes Salgueira Lazo
- Sociedad Española de Nefrología (SEN), Unidad de Nefrología, Hospital Universitario Virgen Macarena de Sevilla, Sevilla, España
| | - María Mar Castellanos Rodrigo
- Sociedad Española de Neurología (SEN), Servicio de Neurología Complejo Hospitalario Universitario A Coruña/Instituto de Investigación Biomédica A Coruña, Coruña, España
| | - José María Mostaza Prieto
- Sociedad Española de Arteriosclerosis (SEA), Servicio de Medicina Interna, Hospital La Paz-Carlos III, Madrid, España
| | - Juan José Gómez Doblas
- Sociedad Española de Cardiología (SEC), Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, España
| | - Antonio Buño Soto
- Sociedad Española de Medicina de Laboratorio (SEQCML), Servicio de Análisis Clínicos, Hospital Universitario La Paz, Madrid, España
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Kalbitzer T, Lobenhofer K, Martin S, Beck Erlach M, Kremer W, Kalbitzer HR. NMR derived changes of lipoprotein particle concentrations related to impaired fasting glucose, impaired glucose tolerance, or manifest type 2 diabetes mellitus. Lipids Health Dis 2023; 22:42. [PMID: 36964528 PMCID: PMC10037821 DOI: 10.1186/s12944-023-01801-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/06/2023] [Indexed: 03/26/2023] Open
Abstract
Background Type 2 diabetes mellitus (T2D) and corresponding borderline states, impaired fasting glucose (IFG) and/or glucose tolerance (IGT), are associated with dyslipoproteinemia. It is important to distinguish between factors that cause T2D and that are the direct result of T2D. Methods The lipoprotein subclass patterns of blood donors with IFG, IGT, with IFG combined with IGT, and T2D are analyzed by nuclear magnetic resonance (NMR) spectroscopy. The development of lipoprotein patterns with time is investigated by using samples retained for an average period of 6 years. In total 595 blood donors are classified by oral glucose tolerance test (oGTT) and their glycosylated hemoglobin (HbA1c) concentrations. Concentrations of lipoprotein particles of 15 different subclasses are analyzed in the 10,921 NMR spectra recorded under fasting and non-fasting conditions. The subjects are assumed healthy according to the strict regulations for blood donors before performing the oGTT. Results Under fasting conditions manifest T2D exhibits a significant concentration increase of the smallest HDL particles (HDL A) combined with a decrease in all other HDL subclasses. In contrast to other studies reviewed in this paper, a general concentration decrease of all LDL particles is observed that is most prominent for the smallest LDL particles (LDL A). Under normal nutritional conditions a large, significant increase of the concentrations of VLDL and chylomicrons is observed for all groups with IFG and/or IGT and most prominently for manifest T2D. As we show it is possible to obtain an estimate of the concentrations of the apolipoproteins Apo-A1, Apo-B100, and Apo-B48 from the NMR data. In the actual study cohort, under fasting conditions the concentrations of the lipoproteins are not increased significantly in T2D, under non-fasting conditions only Apo-B48 increases significantly. Conclusion In contrast to other studies, in our cohort of “healthy” blood donors the T2D associated dyslipoproteinemia does not change the total concentrations of the lipoprotein particles produced in the liver under fasting and non-fasting conditions significantly but only their subclass distributions. Compared to the control group, under non-fasting conditions participants with IGT and IFG or T2D show a substantial increase of plasma concentrations of those lipoproteins that are produced in the intestinal tract. The intestinal insulin resistance becomes strongly observable.
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Affiliation(s)
- Tina Kalbitzer
- grid.7727.50000 0001 2190 5763Institute of Biophysics and Physical Biochemistry and Centre of Magnetic Resonance in Chemistry and Biomedicine, University of Regensburg, Universitätsstr. 31, 93040 Regensburg, Germany
| | - Kristina Lobenhofer
- grid.7727.50000 0001 2190 5763Institute of Biophysics and Physical Biochemistry and Centre of Magnetic Resonance in Chemistry and Biomedicine, University of Regensburg, Universitätsstr. 31, 93040 Regensburg, Germany
| | - Silke Martin
- Blutspendedienst des Bayerischen Roten Kreuzes Gemeinnützige GmbH, Herzog-Heinrich-Straße 2, 80336 Munich, Germany
| | - Markus Beck Erlach
- grid.7727.50000 0001 2190 5763Institute of Biophysics and Physical Biochemistry and Centre of Magnetic Resonance in Chemistry and Biomedicine, University of Regensburg, Universitätsstr. 31, 93040 Regensburg, Germany
| | - Werner Kremer
- grid.7727.50000 0001 2190 5763Institute of Biophysics and Physical Biochemistry and Centre of Magnetic Resonance in Chemistry and Biomedicine, University of Regensburg, Universitätsstr. 31, 93040 Regensburg, Germany
| | - Hans Robert Kalbitzer
- grid.7727.50000 0001 2190 5763Institute of Biophysics and Physical Biochemistry and Centre of Magnetic Resonance in Chemistry and Biomedicine, University of Regensburg, Universitätsstr. 31, 93040 Regensburg, Germany
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19
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Arrobas Velilla T, Guijarro C, Campuzano Ruiz R, Rodríguez Piñero M, Valderrama Marcos JF, Pérez Pérez A, Botana López MA, Morais López A, García Donaire JA, Obaya JC, Castilla Guerra L, Pallares Carratalá V, Egocheaga Cabello I, Salgueira Lazo M, Castellanos Rodrigo MM, Mostaza Prieto JM, Gómez Doblas JJ, Buño Soto A. Consensus document for lipid profile determination and reporting in Spanish clinical laboratories. What parameters should be included in a basic lipid profile? CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2023; 35:91-100. [PMID: 36925360 DOI: 10.1016/j.arteri.2022.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 03/16/2023]
Abstract
Cardiovascular diseases (CVD) continue to be the main cause of death in our country. Adequate control of lipid metabolism disorders is a key challenge in cardiovascular prevention that is far from being achieved in real clinical practice. There is a great heterogeneity in the reports of lipid metabolism from Spanish clinical laboratories, which may contribute to its poor control. For this reason, a working group of the main scientific societies involved in the care of patients at vascular risk, has prepared this document with a consensus proposal on the determination of the basic lipid profile in cardiovascular prevention, recommendations for its realization and unification of criteria to incorporate the lipid control goals appropriate to the vascular risk of the patients in the laboratory reports.
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Affiliation(s)
- Teresa Arrobas Velilla
- Sociedad Española de Medicina de Laboratorio (SEQCML), Laboratorio de Bioquímica Clínica, Hospital Universitario Virgen Macarena de Sevilla, Sevilla, España. Investigador Asociado, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago de Chile, Chile
| | - Carlos Guijarro
- Sociedad Española de Arteriosclerosis (SEA), Unidad de Medicina Interna, Hospital Universitario Fundación de Alcorcón, Universidad Rey Juan Carlos, Madrid, España.
| | - Raquel Campuzano Ruiz
- Sociedad Española de Cardiología (SEC), Unidad de Cardiología, Hospital Universitario Fundación de Alcorcón, Asociación de Riesgo vascular y Rehabilitación Cardiaca de la Sociedad Española de Cardiología, Madrid, España
| | - Manuel Rodríguez Piñero
- Sociedad Española de Angiología y Cirugía Vascular (SEACV), Unidad Intercentros Cádiz-Jerez de Angiología y Cirugía Vascular, Hospital Universitario Puerta del Mar, Cádiz, España
| | - José Francisco Valderrama Marcos
- Sociedad Española de Cirugía Cardiovascular y Endovascular (SECCE), Cirugía Cardiovascular, Hospital Regional Universitario de Málaga, Málaga, España
| | - Antonio Pérez Pérez
- Sociedad Española de Diabetes (SED), Servicio de Endocrinología y Nutrición, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - Manuel Antonio Botana López
- Sociedad Española de Endocrinología y Nutrición (SEEN), Sección de Endocrinología, Hospital Universitario Lucus Augusti, Lugo, España
| | - Ana Morais López
- Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica (SEGHNP), Unidad de Nutrición Infantil y Enfermedades Metabólicas, Hospital Universitario La Paz, Madrid, España
| | - José Antonio García Donaire
- Sociedad Española de Hipertensión, Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA), Unidad de Hipertensión Arterial, Hospital Clínico Universitario San Carlos, Madrid, España
| | - Juan Carlos Obaya
- Sociedad Española de Medicina de Familia y Comunitaria (SEMFyC), Medicina Familiar y Comunitaria, CS La Chopera, Alcobendas, Madrid, España
| | - Luis Castilla Guerra
- Sociedad Española de Medicina Interna (SEMI), Unidad de Hipertensión, Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital Virgen Macarena, PCDV Departamento de Medicina, Universidad de Sevilla, Sevilla, España
| | - Vicente Pallares Carratalá
- Sociedad Española de Médicos de Atención Primaria (SEMERGEN), Unidad de Vigilancia de la Salud, Unión de Mutuas, Departamento de Medicina, Universitat Jaume I, Castellón, Castellón, España
| | - Isabel Egocheaga Cabello
- Sociedad Española de Médicos Generales y de Familia (SEMG), Medicina Familiar y Comunitaria, Centro de Salud Isla de Oza, Servicio Madrileño de Salud, Madrid, España
| | - Mercedes Salgueira Lazo
- Sociedad Española de Nefrología (SEN), Unidad de Nefrología, Hospital Universitario Virgen Macarena de Sevilla, Sevilla, España
| | - María Mar Castellanos Rodrigo
- Sociedad Española de Neurología (SEN), Servicio de Neurología Complejo Hospitalario Universitario A Coruña/Instituto de Investigación Biomédica A Coruña, Coruña, España
| | - José María Mostaza Prieto
- Sociedad Española de Arteriosclerosis (SEA), Servicio de Medicina Interna, Hospital La Paz-Carlos III, Madrid, España
| | - Juan José Gómez Doblas
- Sociedad Española de Cardiología (SEC), Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, España
| | - Antonio Buño Soto
- Sociedad Española de Medicina de Laboratorio (SEQCML), Servicio de Análisis Clínicos, Hospital Universitario La Paz, Madrid, España
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20
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Cholesterol Remnants, Triglyceride-Rich Lipoproteins and Cardiovascular Risk. Int J Mol Sci 2023; 24:ijms24054268. [PMID: 36901696 PMCID: PMC10002331 DOI: 10.3390/ijms24054268] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/17/2023] [Accepted: 02/19/2023] [Indexed: 02/23/2023] Open
Abstract
Randomized clinical trials with statins and other lipid-lowering drugs have shown the presence of a "residual cardiovascular risk" in those treated to "target" for LDL-cholesterol. This risk is mainly associated to lipid components other than LDL and in particular to remnant cholesterol (RC) and to lipoproteins rich in triglycerides in fasting and non-fasting conditions. During fasting, RCs correspond to the cholesterol content of the VLDL and their partially depleted triglyceride remnant containing apoB-100. Conversely, in non-fasting conditions, RCs include also cholesterol present in chylomicrons containing apoB-48. Therefore, RCs refer to total plasma cholesterol minus HDL-cholesterol and LDL-cholesterol, that is, all the cholesterol present in the VLDL, chylomicrons and in their remnants. A large body of experimental and clinical data suggests a major role of RCs in the development of atherosclerosis. In fact, RCs easily pass the arterial wall and bind to the connective matrix stimulating the progression of smooth muscle cells and the proliferation of resident macrophages. RCs are a causal risk factor for cardiovascular events. Fasting and non-fasting RCs are equivalent for predicting vascular events. Further studies on drugs effect on RC levels and clinical trials to evaluate the efficacy of RC reduction on cardiovascular events are needed.
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Arrobas T, Guijarro C, Campuzano R, Rodríguez Piñero M, Valderrama Marcos JF, Botana López AM, Morais López A, García Donaire JA, Obaya JC, Castilla Guerra L, Pallarés Carratalà V, Egocheaga Cabello I, Salgueira Lazo M, Castellanos Rodrigo MM, Mostaza Prieto JM, Gómez Doblas JJ, Buño Soto A. Documento de consenso para la determinación e informe del perfil lipídico en laboratorios clínicos españoles. REVISTA CLÍNICA DE MEDICINA DE FAMILIA 2023. [DOI: 10.55783/rcmf.160106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Las enfermedades cardiovasculares (ECV) siguen siendo la principal causa de muerte en nuestro país. El control adecuado de las alteraciones del metabolismo lipídico es un reto clave en prevención cardiovascular que está lejos de alcanzarse en la práctica clínica real. Existe una gran heterogeneidad en los informes del metabolismo lipídico de los laboratorios clínicos españoles, lo que puede contribuir al mal control del mismo. Por ello, un grupo de trabajo de las principales sociedades científicas implicadas en la atención de los pacientes de riesgo vascular, hemos elaborado este documento con una propuesta básica de consenso sobre la determinación del perfil lipídico básico en prevención cardiovascular, recomendaciones para su realización y unificación de criterios para incorporar los objetivos de control lipídico adecuados al riesgo vascular de los pacientes en los informes de laboratorio.
Palabras clave: consenso, panel de lípidos, enfermedades cardiovasculares, bioquímica, colesterol, lípidos, triglicéridos, lipoproteína (a).
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Affiliation(s)
- Teresa Arrobas
- Miembro de la Sociedad Española de Medicina de Laboratorio (SEQCML). Laboratorio de Bioquímica Clínica. Hospital Universitario Virgen Macarena. Sevilla (España). Los tres autores han contribuido de manera equivalente en la redacción del documento
| | - Carlos Guijarro
- Miembro de la Sociedad Española de Arteriosclerosis (SEA). Unidad de Medicina Interna. Hospital Universitario Fundación de Alcorcón. Universidad Rey Juan Carlos. Madrid (España).Los tres autores han contribuido de manera equivalente en la redacción del documento
| | - Raquel Campuzano
- Miembro de la Sociedad Española de Cardiología (SEC). Unidad de Cardiología. Hospital Universitario Fundación de Alcorcón. Madrid (España). Los tres autores han contribuido de manera equivalente en la redacción del documento
| | - Manuel Rodríguez Piñero
- Miembro de la Sociedad Española de Angiología y Cirugía Vascular (SEACV). Unidad Intercentros Cádiz - Jerez de Angiología y Cirugía Vascular. Hospital Universitario Puerta del Mar. Cádiz (España)
| | - José Francisco Valderrama Marcos
- Miembro de la Sociedad Española de Cirugía Cardiovascular y Endovascular (SECCE). Hospital Regional Universitario de Málaga. Málaga (España)
| | - Antonio M. Botana López
- Miembro de la Sociedad Española de Endocrinología y Nutrición (SEEN). Sección de Endocrinología. Hospital Universitario Lucus Augusti de Lugo. Lugo (España)
| | - Ana Morais López
- Miembro de la Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica (SEGHNP). Unidad de Nutrición Infantil y Enfermedades Metabólicas. Hospital Universitario La Paz. Madrid (España)
| | - José Antonio García Donaire
- Miembro de la Sociedad Española de Hipertensión - Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA). Unidad de Hipertensión Arterial. Hospital Clínico Universitario San Carlos. Madrid (España)
| | - Juan Carlos Obaya
- Sociedad Española de Medicina de Familia y Comunitaria (semFYC). Especialista en Medicina Familiar y Comunitaria. CS La Chopera. Alcobendas. Madrid (España)
| | - Luis Castilla Guerra
- Miembro de la Sociedad Española de Medicina Interna (SEMI). Unidad de Hipertensión, Lípidos y Riesgo Vascular. Servicio de Medicina Interna. Hospital Virgen Macarena. PCDV Departamento de Medicina. Universidad de Sevilla. Sevilla (España)
| | - Vicente Pallarés Carratalà
- Miembro de la Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Unidad de Vigilancia de la Salud. Unión de Mutuas. Universitat Jaume I. Castellón (España)
| | - Isabel Egocheaga Cabello
- Miembro de la Sociedad Española de Médicos Generales y de Familia (SEMG). Especialista en Medicina Familiar y Comunitaria. CS Isla de Oza. Madrid (España)
| | - Mercedes Salgueira Lazo
- Miembro de la Sociedad Española de Nefrología (SEN). Unidad de Nefrología. Hospital Universitario Virgen Macarena. Sevilla (España)
| | - María Mar Castellanos Rodrigo
- Miembro de la Sociedad Española de Neurología (SEN). Servicio de Neurología. Complejo Hospitalario Universitario A Coruña - Instituto de Investigación Biomédica A Coruña. A Coruña (España). Coordinadora del Grupo de Estudio de Enfermedades Cerebrovasculares de la SEN
| | - José María Mostaza Prieto
- Miembro de la Sociedad Española de Arterioesclerosis (SEA). Unidad de Medicina Interna. Hospital Carlos III de Madrid. Madrid (España)
| | - Juan José Gómez Doblas
- Miembro de la Sociedad Española de Cardiología (SEC). Unidad de Cardiología del Hospital Universitario Virgen de la Victoria. Málaga (España)
| | - Antonio Buño Soto
- Miembro de la Sociedad Española de Medicina de Laboratorio. Servicio de Análisis Clínicos. Hospital Universitario la Paz. Madrid (España)
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22
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Yi KC, Heseltine JC, Jeffery ND, Cook AK, Nabity MB. Effect of withholding food versus feeding on creatinine, symmetric dimethylarginine, cholesterol, triglycerides, and other biochemical analytes in 100 healthy dogs. J Vet Intern Med 2023; 37:626-634. [PMID: 36786663 DOI: 10.1111/jvim.16630] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 01/05/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Withholding food is often recommended before collection of blood for routine biochemical analysis in dogs despite a paucity of evidence to support this requirement. OBJECTIVES To compare measurements of selected biochemical analytes collected before and after feeding in clinically healthy dogs. ANIMALS One hundred clinically healthy staff- and student-owned dogs weighing ≥15 kg. METHODS Prospective observational study. Food was withheld from the dogs for 10-26 hours. Preprandial serum was collected, and then dogs were fed their usual food at an amount equivalent to at least 2/3 resting energy requirement (RER). Selected serum analytes were measured at 2-, 4-, 6-, and 8-hours postprandially. The proportion of postprandial values that exceeded either the reported allowable total error (TEa), or for symmetric dimethylarginine (SDMA), the reference change value (RCV), was determined. As neither TEa nor RCV is available for lipase, comparison was made to the high end of the reference interval (RI). RESULTS The proportion of dogs with at least 1 postprandial measurement that exceeded the TEa or RCV was 92/100 for triglycerides, 66/100 for blood urea nitrogen (BUN), 46/100 for phosphorus, 17/100 for glucose, 9/100 for bilirubin, 5/100 for SDMA, 2/100 for creatinine, and 0/100 for cholesterol and albumin. Postprandial lipase never exceeded the RI in dogs with normal fasted lipase. CONCLUSIONS AND CLINICAL IMPORTANCE Withholding food is generally not necessary before performing routine biochemical analysis in clinically healthy dogs. Withholding food might be helpful to limit variability in analytes impacted by feeding, such as triglycerides and phosphorus.
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Affiliation(s)
- Katarina C Yi
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Johanna C Heseltine
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Nicholas D Jeffery
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Audrey K Cook
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Mary B Nabity
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
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23
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Fu Z, Liu Q, Liang J, Weng Z, Li W, Xu J, Zhang X, Xu C, Gu A. Association between NMR metabolomic signatures of healthy lifestyle and incident coronary artery disease. Eur J Prev Cardiol 2023; 30:243-253. [PMID: 36317303 DOI: 10.1093/eurjpc/zwac252] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/26/2022] [Accepted: 10/28/2022] [Indexed: 11/05/2022]
Abstract
AIMS To identify metabolites associated with a healthy lifestyle and explore the possible mechanisms of lifestyle in coronary artery disease (CAD). METHODS AND RESULTS The nuclear magnetic resonance metabolomics platform was applied to perform metabolomic profiling of baseline plasma samples from a randomly selected subset of 121 733 UK Biobank participants. Cox proportional hazards models with covariate adjustments were used to investigate the associations between validated lifestyle-associated metabolites and incident CAD and to estimate the accuracy of the inclusion of metabolites to predict CAD compared with traditional prediction models. The discriminatory ability of each model was evaluated using Harrell's C statistic, integrated discrimination improvement (IDI), and continuous net reclassification improvement (NRI) indexes. During a median of 8.6 years of follow-up, 5513 incident CAD cases were documented. Among the 111 lifestyle-associated metabolites, 65 were significantly associated with incident CAD after multivariate adjustment (Bonferroni P < 3.11 × 10-04). The addition of these metabolites to classic risk prediction models [Framingham Risk Score (FRS) using lipids; FRS using body mass index] improved CAD prediction accuracy as assessed by the C statistic (increasing to 0.739 [95% CI, 0.731-0.747] and 0.752 [95% CI, 0.746-0.758]), respectively; continuous NRI (0.274 [0.227-0.325] and 0.266 [0.223-0.317]) and IDI (0.003 [0.002-0.004] and 0.003 [0.002-0.004]). CONCLUSION Healthy lifestyle-associated metabolites are associated with the incidence of CAD and may help improve the prediction of CAD risk. The use of metabolite information combined with the FRS model warrants further investigation before clinical implementation.
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Affiliation(s)
- Zuqiang Fu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China
- School of Public Health, Southeast University, 87 Dingjiaqiao, Nanjing 210009, China
| | - Qian Liu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China
| | - Jingjia Liang
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China
| | - Zhenkun Weng
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China
| | - Wenxiang Li
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China
| | - Jin Xu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China
- Department of Maternal, Child, and Adolescent Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China
| | - Xin Zhang
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China
| | - Cheng Xu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China
| | - Aihua Gu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, Center for Global Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China
- School of Public Health, Southeast University, 87 Dingjiaqiao, Nanjing 210009, China
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Kivlehan E, Gaebler-Spira D, Chen L, Garrett A, Wysocki N, Marciniak C. Relationship of anthropometric measurements and percent body fat mass to cardiovascular disease risk factors in adults with cerebral palsy. PM R 2023; 15:192-202. [PMID: 35235238 DOI: 10.1002/pmrj.12797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 01/23/2022] [Accepted: 01/24/2022] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Adults with cerebral palsy (CP) face high morbidity from cardiovascular disease (CVD). Of concern, classic screening parameters are inconsistent in identifying CVD risk in this population. Dual-energy x-ray absorptiometry (DEXA), which provides direct measurements of fat mass (FM), may be an alternative screening method. OBJECTIVE To evaluate whether FM measurement with DEXA is feasible in screening adults with CP and compare FM and anthropometric measures to CVD risk factors. DESIGN Cross-sectional study. SETTING Outpatient rehabilitation hospital. PARTICIPANTS Forty-seven adults with CP. MAIN OUTCOME MEASURES Weight, height, waist circumference (WC), and hip circumference (HC) were measured; waist-to-hip ratio (WHR) and body mass index (BMI) were calculated. Blood pressure (BP), FM by DEXA, hemoglobin A1c (HbA1c), and lipid measurements were obtained. Logistic regression models investigated odds ratios (ORs) and 95% confidence intervals (CIs) between anthropometric measurements/FM and CVD risk factors; correlations were assessed using Pearson correlation coefficients. RESULTS Elevated BP or hypertension diagnosis was present in 47.8%; HbA1c ≥5.7% in 22.2%; and high-density lipoprotein (HDL) level below optimal for 33.3%. DEXA FM was obtained in 29 of 47 participants, as surgical metal and positioning limited many studies. Excess FM was noted in 75.9% versus 41.3% overweight/obese by BMI. WC correlated with HbA1c (r = 0.46, p = .002), HDL (r = -0.36, p = .018), and triglyceride (TG) levels (r = 0.30, p = .045); however at-risk WC values were associated only with odds of elevated HbA1c (OR 8.53, 95% CI 1.46-50.05; p = .018). HC correlated with HbA1c levels (r = 0.38, p = .011) and systolic BPs (r = 0.35, p = .019); similarly, ORs for elevated HC were weakly associated with elevated HbA1c and BPs (OR 1.08, 95% CI 1.01-1.16; p = .024 and OR 1.07, 95% CI 1.01-1.14; p = .024, respectively). WHR correlated with TGs; however few TG levels were elevated. FM measures were not associated with at-risk lab values or BPs. CONCLUSIONS DEXA FM measurements may not be feasible for CVD screening in many adults with CP. Although CVD risk factors are frequently present, anthropometric measurements commonly used for general population screening may not translate well to adults with CP.
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Affiliation(s)
- Emily Kivlehan
- Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
| | - Deborah Gaebler-Spira
- Shirley Ryan AbilityLab, Chicago, Illinois, USA.,Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Department of Pediatric Rehabilitation, Shirley Ryan AbilityLab, Chicago, Illinois, USA
| | - Liqi Chen
- Biostatistics Collaboration Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Nicole Wysocki
- Shirley Ryan AbilityLab, Chicago, Illinois, USA.,Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Christina Marciniak
- Shirley Ryan AbilityLab, Chicago, Illinois, USA.,Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Sridhar VS, Liu H, Lovblom LE, Feig DS, Herer E, Hladunewich MA, Kiss A, Kohly RP, Lipscombe LL, Yip PM, Cherney DZ, Shah BR. Associations Among Biomarkers of Inflammation, Tubular Injury and Lipid Metabolism With Gestational Diabetes Mellitus Status, Microalbuminuria and Retinopathy in the Microalbuminuria and Retinopathy in Gestational Diabetes Study. Can J Diabetes 2023; 47:43-50.e3. [PMID: 36180335 DOI: 10.1016/j.jcjd.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 06/04/2022] [Accepted: 07/19/2022] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Pregnancy may be complicated by gestational diabetes mellitus (GDM) and/or microvascular complications like albuminuria, retinopathy and pre-eclampsia. In this study we aimed to identify whether mechanistic pathways associated with microvascular complications are active in pregnant women with GDM or microvascular disease. METHODS Urinary albumin excretion and biomarkers of inflammation, lipoprotein metabolism and tubular injury were quantified in 355 pregnant women with and without GDM. Participants underwent fundus photography graded for retinopathy. Adjusted associations between individual biomarkers and each outcome variable of interest, including GDM status, albuminuria and retinopathy, were performed using logistic regression. RESULTS After adjusting for age, systolic blood pressure, body mass index and ethnicity, significant associations between GDM status and apolipoprotein A1, interleukin (IL)-6, IL-8, soluble tumour necrosis factor receptor-I and -II (sTNFR-I and -II), vascular endothelial growth factor and von Willebrand factor were observed. Increased high-sensitivity C-reactive protein (hsCRP) and sTNFR-II were associated with higher levels of albuminuria. hsCRP and previous GDM were associated with retinopathy. CONCLUSION Mechanistic pathways associated with microvascular complications appear to be active in pregnant women with GDM or microvascular disease.
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Affiliation(s)
- Vikas S Sridhar
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada; Department of Medicine, Division of Nephrology, University Health Network, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Hongyan Liu
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada; Department of Medicine, Division of Nephrology, University Health Network, Toronto, Ontario, Canada
| | - Leif Erik Lovblom
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada
| | - Denice S Feig
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Elaine Herer
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada
| | - Michelle A Hladunewich
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Sunnybrook Research Institute, Toronto, Ontario, Canada
| | | | - Radha P Kohly
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Lorraine L Lipscombe
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Women's College Hospital, Toronto, Ontario, Canada
| | - Paul M Yip
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - David Z Cherney
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada; Department of Medicine, Division of Nephrology, University Health Network, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Baiju R Shah
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Sunnybrook Research Institute, Toronto, Ontario, Canada.
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Imano H, Li J, Tanaka M, Yamagishi K, Muraki I, Umesawa M, Kiyama M, Kitamura A, Sato S, Iso H. Optimal Cut-off Points of Nonfasting and Fasting Triglycerides for Prediction of Ischemic Heart Disease in Japanese General Population: The Circulatory Risk in Communities Study (CIRCS). J Atheroscler Thromb 2023; 30:110-130. [PMID: 35444102 PMCID: PMC9925200 DOI: 10.5551/jat.63358] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 02/24/2022] [Indexed: 02/04/2023] Open
Abstract
AIMS We investigated the optimal cut-off points of nonfasting and fasting triglycerides in Japanese individuals with lower average triglyceride levels than westerners. METHODS Residents aged 40-69 years without a history of ischemic heart disease or stroke were enrolled between 1980 and 1994 and followed. Serum triglyceride concentrations were measured from 10851 nonfasting (<8 h after meal) and 4057 fasting (≥ 8 h) samples. As a prerequisite, we confirmed the shape of a receiver operating characteristic (ROC) curves, the area under ROC curves (AUC), and the integrated time-dependent AUC. We identified optimal cut-off points for incident ischemic heart disease based on C-statistic, Youden index, and Harrell's concordance statistic. We used dichotomized concentrations of triglycerides via the univariate logistic regression and Cox proportional hazards regression models. We also calculated multivariable hazard ratios and population attributable fractions to evaluate the optimal cut-off points. RESULTS Nonfasting and fasting optimal cut-off points were 145 mg/dL and 110 mg/dL, with C-statistic of 0.594 and 0.626, Youden index of 0.187 and 0.252, and Harrell's concordance statistic of 0.590 and 0.630, respectively. The corresponding multivariable hazard ratios of ischemic heart disease were 1.43 (95%CI 1.09-1.88) and 1.69 (1.03-2.77), and the corresponding population attributable fractions were 16.1% (95%CI 3.3-27.2%) and 24.6 (-0.3-43.3). CONCLUSION The optimal cut-off points of nonfasting and fasting triglycerides in the Japanese general population were 145 mg/dL and 110 mg/dL, respectively, lower than the current cut-off points recommended in the US and Europe.
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Affiliation(s)
- Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Public Health, Kindai University Faculty of Medicine, Osaka, Japan
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Jiaqi Li
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Mari Tanaka
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba
- Ibaraki Western Medical Center, Ibaraki, Japan
| | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Mitsumasa Umesawa
- Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | | | - Shinichi Sato
- Chiba Prefectural Institute of Public Health, Chiba, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Institute for Global Health Polycy Research (iGHP), National Center for Global Health and Medicine, Tokyo, Japan
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Takeda Y, Sakuma I, Hiramitsu S, Okada M, Ueda S, Sakurai M. The effects of pemafibrate and omega-3 fatty acid ethyl on apoB-48 in dyslipidemic patients treated with statin: A prospective, multicenter, open-label, randomized, parallel group trial in Japan (PROUD48 study). Front Cardiovasc Med 2023; 10:1094100. [PMID: 36760560 PMCID: PMC9905248 DOI: 10.3389/fcvm.2023.1094100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/06/2023] [Indexed: 01/27/2023] Open
Abstract
Background We compared the lowering effects of pemafibrate and omega-3 fatty acid ethyl on fasting apolipoprotein (apo) B-48 (apoB-48), a marker that reflects postprandial hypertriglyceridemia, which is one of the residual risks for atherosclerotic cardiovascular disease (ASCVD) with statin treatment. Methods This prospective, multicenter, open-label, randomized, parallel group trial was conducted at 4 medical institutions between April 2020 and May 2022. A total of 126 ambulatory patients with dyslipidemia receiving statin treatment for more than 4 weeks, aged 20-79 years with fasting triglyceride (TG) levels of ≥177 mg/dl were randomly assigned to 16-week pemafibrate 0.4 mg per day treatment group (PEMA, n = 63) or omega-3 fatty acid ethyl 4 g per day treatment group (OMEGA-3, n = 63). The primary endpoint was the percentage change in fasting apoB-48 from baseline to week 16. Results The percentage changes in fasting apoB-48 in PEMA and OMEGA-3 were -50.8% (interquartile range -62.9 to -30.3%) and -17.5% (-38.3 to 15.3%) (P < 0.001), respectively. As the secondary endpoints, the changes in fasting apoB-48 in PEMA and OMEGA-3 were -3.10 μg/ml (-5.63 to -1.87) and -0.90 μg/ml (-2.95 to 0.65) (P < 0.001), respectively. Greater decreases with significant differences in the percentage changes in TG, remnant lipoprotein cholesterol, apoC-III, fasting plasma glucose, alanine aminotransferase, gamma-glutamyl transpeptidase, and alkaline phosphatase were observed in PEMA, compared with OMEGA-3. Greater increases with significant differences in those in high-density lipoprotein (HDL) cholesterol, apoA-I, and apoA-II were observed in PEMA, compared with OMEGA-3. PEMA showed anti-atherosclerotic lipoprotein profiles in gel-permeation high-performance liquid chromatography analyses, compared with OMEGA-3. Although adverse events occurred in 9 of 63 (14.3%) patients in PEMA and 3 of 63 (4.8%) patients in OMEGA-3, no serious adverse events associated with drug were observed in either group. Conclusions This is the first randomized trial to compare the lowering effects of pemafibrate and omega-3 fatty acid ethyl on fasting apoB-48. We concluded that pemafibrate was superior to omega-3 fatty acid ethyl in lowering effect of fasting apoB-48. Pemafibrate is expected to reduce the residual risk for ASCVD with statin treatment. Clinical trial registration https://rctportal.niph.go.jp/en, identifier jRCTs071200011.
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Affiliation(s)
- Yasutaka Takeda
- Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan,*Correspondence: Yasutaka Takeda,
| | - Ichiro Sakuma
- Caress Sapporo Hokko Memorial Clinic, Sapporo, Japan
| | | | | | - Shinichiro Ueda
- Department of Clinical Pharmacology and Therapeutics, University of the Ryukyus, Nishihara, Japan
| | - Masaru Sakurai
- Department of Social and Environmental Medicine, Kanazawa Medical University, Uchinada, Japan
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Qureshi F, Guimond A, Tsao E, Delaney S, Boehm JK, Kubzansky LD. Adolescent Psychological Assets and Cardiometabolic Health Maintenance in Adulthood: Implications for Health Equity. J Am Heart Assoc 2023; 12:e026173. [PMID: 36628968 PMCID: PMC9939070 DOI: 10.1161/jaha.122.026173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background Positive cardiometabolic health (CMH) is defined as meeting recommended levels of multiple cardiometabolic risk factors in the absence of manifest disease. Prior work finds that few individuals-particularly members of minoritized racial and ethnic groups-meet these criteria. This study investigated whether psychological assets help adolescents sustain CMH in adulthood and explored interactions by race and ethnicity. Methods and Results Participants were 3478 individuals in the National Longitudinal Study of Adolescent Health (49% female; 67% White, 15% Black, 11% Latinx, 6% other [Native American, Asian, or not specified]). In Wave 1 (1994-1995; mean age=16 years), data on 5 psychological assets (optimism, happiness, self-esteem, belongingness, and feeling loved) were used to create a composite asset index (range=0-5). In Waves 4 (2008; mean age=28 years) and 5 (2016-2018; mean age=38 years), CMH was defined using 7 clinically assessed biomarkers. Participants with healthy levels of ≥6 biomarkers at Waves 4 and 5 were classified as maintaining CMH over time. The prevalence of CMH maintenance was 12%. Having more psychological assets was associated with better health in adulthood (odds ratio [OR]linear trend, 1.12 [95% CI, 1.01-1.25]). Subgroup analyses found substantive associations only among Black participants (OR, 1.35 [95% CI, 1.00-1.82]). Additionally, there was some evidence that racial and ethnic disparities in CMH maintenance may be less pronounced among participants with more assets. Conclusions Youth with more psychological assets were more likely to experience favorable CMH patterns 2 decades later. The strongest associations were observed among Black individuals. Fostering psychological assets in adolescence may help prevent cardiovascular disease and play an underappreciated role in shaping health inequities.
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Affiliation(s)
- Farah Qureshi
- Department of Population, Family and Reproductive HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMD
| | - Anne‐Josee Guimond
- Department of Social and Behavioral SciencesHarvard T.H. Chan School of Public HealthBostonMA,Lee Kum Sheung Center for Health and HappinessHarvard T.H. Chan School of Public HealthBostonMA
| | - Elaine Tsao
- Department of Social and Behavioral SciencesHarvard T.H. Chan School of Public HealthBostonMA,Lee Kum Sheung Center for Health and HappinessHarvard T.H. Chan School of Public HealthBostonMA
| | - Scott Delaney
- Department of Social and Behavioral SciencesHarvard T.H. Chan School of Public HealthBostonMA,Lee Kum Sheung Center for Health and HappinessHarvard T.H. Chan School of Public HealthBostonMA
| | | | - Laura D. Kubzansky
- Department of Social and Behavioral SciencesHarvard T.H. Chan School of Public HealthBostonMA,Lee Kum Sheung Center for Health and HappinessHarvard T.H. Chan School of Public HealthBostonMA
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Güven C, Pala AA, Urcun YS. Effects of plasma atherogenic index and plasma osmolality on arteriovenous fistula patency in hemodialysis patients. J Vasc Access 2023; 24:64-70. [PMID: 34112020 DOI: 10.1177/11297298211011864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The purpose of the present study was to investigate the effects of Plasma atherogenic index (AIP) and plasma osmolality (PO) values on arteriovenous fistula (AVF) patency in patients with chronic renal failure. METHODS The patients with primary AVF between December 2012 and March 2020 with the diagnosis of end-stage renal disease in our clinic were included in the study. The patient data were collected retrospectively in digital medium. Diabetic patients were not included in the study. The Triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), sodium (Na), fasting blood glucose, and blood urea nitrogen (BUN) values were found and recorded from the files. AIP and PO were calculated with special formulas. Fistula patency rate in 6th, 12th, and 24th months were evaluated in 2-year follow-ups. RESULTS According to the results of two-year follow-ups of the 162 patients, who underwent primary AVF, 21 (13%) patients were found to have thrombosis in the 6th month, 33 (20.4%) patients in the 12th month; however,141 (87%) and 129 (79.6%) patients actively used AVF in the 6th and 12th months, respectively. The AIP and PO values that were calculated in the patient group with AVF thrombosis were significantly higher (p = 0.001, p < 0.001; respectively). In the multivariate logistic regression analysis, Na, BUN, and HDL-C variables were found to be independent predictive factors for AVF thrombosis (OR (Odds Ratio): 1.169, 95% CI (Confidence interval)): 1.056-1.294, p = 0.003; OR: 1.108, 95% CI: 1.043-1.176, p = 0.001; OR: 0.874, 95% CI: 0.820-0.932, p < 0.001; respectively). It was also found that the patency rate was 64.2% (104 patients) in the 24th month. CONCLUSION AIP, PO, Na, and BUN values are positively associated with AVF thrombosis. Checking AIP, Na, and BUN values will be useful in patients with end-term renal failure, who already have difficulties in renal replacement methods and vascular access.
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Affiliation(s)
- Cengiz Güven
- Department of Cardiovascular Surgery, Adıyaman University, Adıyaman, Turkey
| | - Arda Aybars Pala
- Department of Cardiovascular Surgery, Adıyaman University, Adıyaman, Turkey
| | - Yusuf Salim Urcun
- Department of Cardiovascular Surgery, Adıyaman University, Adıyaman, Turkey
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Takeda Y, Sakuma I, Hiramitsu S, Okada M, Ueda S, Sakurai M. Study protocol of the PROUD48 study comparing the effects of pemafibrate and omega-3 fatty acid ethyl esters on ApoB-48 in statin-treated patients with dyslipidaemia: a prospective, multicentre, open-label, randomised, parallel group trial in Japan. BMJ Open 2022; 12:e061360. [PMID: 36375977 PMCID: PMC9664276 DOI: 10.1136/bmjopen-2022-061360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION This study will compare the lowering effects of pemafibrate and omega-3 fatty acid ethyl esters on fasting apolipoprotein B-48 (apoB-48), a surrogate marker reflecting postprandial hypertriglyceridaemia, which is a residual risk for atherosclerotic cardiovascular disease with statin treatment. METHODS AND ANALYSIS This is a prospective, multicentre, open-label, randomised, parallel group, comparative trial. Adult Japanese patients with dyslipidaemia receiving statin treatment for more than 4 weeks with a fasting triglyceride level ≥177 mg/dL will be randomly assigned in a 1:1 ratio to receive pemafibrate (0.4 mg orally per day) or omega-3 fatty acid ethyl esters (4 g orally per day) for 16 weeks. The primary endpoint is the percentage change in fasting apoB-48 from baseline to 16 weeks. The key secondary endpoints include the change in fasting apoB-48 from baseline to 16 weeks, the percentage changes in clinical variables from baseline to 16 weeks and the incidence of adverse events. A total sample size of 128 was set by considering the increased drop-out rate due to the COVID-19 pandemic, in addition to estimation based on a two-sided alpha of 0.05 and a power of 0.8 for apoB-48. ETHICS AND DISSEMINATION The study protocol has been approved by the Certified Review Board of the University of the Ryukyus for Clinical Research Ethics (No. CRB7200001) and will be performed in accordance with the Declaration of Helsinki. Written informed consent will be obtained from all participants. The results of the study will be disseminated through publications and conference presentations to participants, healthcare professionals and the public. TRIAL REGISTRATION NUMBER jRCTs071200011.
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Affiliation(s)
- Yasutaka Takeda
- Department of Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Ichiro Sakuma
- Caress Sapporo Hokko Memorial Clinic, Sapporo, Japan
| | | | | | - Shinichiro Ueda
- Department of Clinical Pharmacology and Therapeutics, University of the Ryukyus, Nishihara, Japan
| | - Masaru Sakurai
- Department of Social and Environmental Medicine, Kanazawa Medical University, Uchinada, Japan
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Pulipati VP, Brinton EA, Hatipoglu B. Management of Mild-to-Moderate Hypertriglyceridemia. Endocr Pract 2022; 28:1187-1195. [PMID: 35850450 DOI: 10.1016/j.eprac.2022.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/07/2022] [Accepted: 07/10/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Hypertriglyceridemia is highly prevalent globally and its prevalence is rising with international increases in the incidence of obesity and diabetes. This review examines current management and future therapies METHODS: For this review, hypertriglyceridemia is defined as mild-to-moderate triglyceride elevation, a fasting or non-fasting triglyceride level >150 mg/dL and <500 mg/dL. We reviewed scientific studies published over the last 30 years and current professional society recommendations regarding evaluation and treatment of hypertriglyceridemia. RESULTS Genetics, lifestyle, and other environmental factors impact triglyceride levels. In adults with mild-to-moderate hypertriglyceridemia, clinicians should routinely assess and treat secondary treatable causes (diet, physical activity, obesity, metabolic syndrome, and reduction or cessation of medications that elevate triglyceride levels). Since atherosclerotic cardiovascular disease (ASCVD) risk is the primary clinical concern, statins are usually first-line treatment. Patients with triglyceride levels between >150 mg/dL and <500 mg/dL whose LDL-C is treated adequately with statins (at "maximally tolerated" doses, per some statements) and have either prior cardiovascular disease or diabetes mellitus plus at least 2 additional cardiovascular disease risk factors should be considered for added icosapent ethyl treatment to further reduce their cardiovascular disease risk. Fibrates, niacin, and other approved agents or agents under development are also reviewed in detail. CONCLUSION The treatment paradigm for mild-to-moderate hypertriglyceridemia is changing based on data from recent clinical trials. Recent trials suggest that the addition of icosapent ethyl to background statin therapy may further reduce ASCVD risk in patients with moderate HTG, though a particular TG goal has not been identified.
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Affiliation(s)
| | | | - Betul Hatipoglu
- Case Western Reserve University School of Medicine, Department of Medicine; University Hospitals Cleveland Medical Center, Department of Medicine, Adult Endocrinology, 11100 Euclid Avenue, Cleveland, OH 44106.
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Wilson PWF, Remaley AT. Ischemic Heart Disease Risk and Remnant Cholesterol Levels. J Am Coll Cardiol 2022; 79:2398-2400. [PMID: 35710190 DOI: 10.1016/j.jacc.2022.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/14/2022] [Indexed: 10/18/2022]
Affiliation(s)
- Peter W F Wilson
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA.
| | - Alan T Remaley
- National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
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Alcala-Diaz JF, Arenas-de Larriva AP, Torres-Peña JD, Rodriguez-Cantalejo F, Rangel-Zuñiga OA, Yubero-Serrano EM, Gutierrez-Mariscal FM, Cardelo MP, Luque RM, Ordovas JM, Perez-Martinez P, Delgado-Lista J, Lopez-Miranda J. A Gene Variation at the ZPR1 Locus (rs964184) Interacts With the Type of Diet to Modulate Postprandial Triglycerides in Patients With Coronary Artery Disease: From the Coronary Diet Intervention With Olive Oil and Cardiovascular Prevention Study. Front Nutr 2022; 9:885256. [PMID: 35782928 PMCID: PMC9247506 DOI: 10.3389/fnut.2022.885256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 05/09/2022] [Indexed: 11/22/2022] Open
Abstract
Background and Aims rs964184 variant in the ZPR1 gene has been associated with blood lipids levels both in fasting and postprandial state and with the risk of myocardial infarction in high-risk cardiovascular patients. However, whether this association is modulated by diet has not been studied. Objective To investigate whether the type of diet (low-fat or Mediterranean diets) interacts with genetic variability at this loci to modulate fasting and postprandial lipids in coronary patients. Materials and Methods The genotype of the rs964184 polymorphism was determined in the Cordioprev Study population (NCT00924937). Fasting and Postprandial triglycerides were assessed before and after 3 years of dietary intervention with either a Mediterranean or a low-fat diet. Postprandial lipid assessment was done by a 4-h oral fat tolerance test (OFTT). Differences in triglycerides levels were identified using repeated-measures ANCOVA. Results From 523 patients (85% males, mean age 59 years) that completed the OFTT at baseline and after 3 years of intervention and had complete genotype information, 125 of them were carriers of the risk allele G. At the start of the study, these patients showed a higher fasting and postprandial triglycerides (TG) plasma levels. After 3 years of dietary intervention, G-carriers following a Mediterranean Diet maintained higher fasting and postprandial triglycerides, while those on the low-fat diet reduced their postprandial triglycerides to similar values to the population without the G-allele. Conclusion After 3 years of dietary intervention, the altered postprandial triglyceride response induced by genetic variability in the rs964184 polymorphism of the ZPR1 gene can be modulated by a low-fat diet, better than by a Mediterranean diet, in patients with coronary artery disease.
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Affiliation(s)
- Juan F. Alcala-Diaz
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
- Centro de Investigación Biomédica en Red de Fisiología de la Obesidad y Nutricion (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio P. Arenas-de Larriva
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
- Centro de Investigación Biomédica en Red de Fisiología de la Obesidad y Nutricion (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Jose D. Torres-Peña
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
- Centro de Investigación Biomédica en Red de Fisiología de la Obesidad y Nutricion (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Oriol A. Rangel-Zuñiga
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
- Centro de Investigación Biomédica en Red de Fisiología de la Obesidad y Nutricion (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Elena M. Yubero-Serrano
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
- Centro de Investigación Biomédica en Red de Fisiología de la Obesidad y Nutricion (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Francisco M. Gutierrez-Mariscal
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
- Centro de Investigación Biomédica en Red de Fisiología de la Obesidad y Nutricion (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Magdalena P. Cardelo
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
- Centro de Investigación Biomédica en Red de Fisiología de la Obesidad y Nutricion (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Raul M. Luque
- Department of Cell Biology, Physiology, and Immunology, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
| | - Jose M. Ordovas
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, United States
- Instituto Madrileño de Estudios Avanzados en Alimentación (IMDEA-Food), Madrid, Spain
- International Advisory Board, University Camilo José Cela, Madrid, Spain
| | - Pablo Perez-Martinez
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
- Centro de Investigación Biomédica en Red de Fisiología de la Obesidad y Nutricion (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Delgado-Lista
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
- Centro de Investigación Biomédica en Red de Fisiología de la Obesidad y Nutricion (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Jose Lopez-Miranda
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
- Centro de Investigación Biomédica en Red de Fisiología de la Obesidad y Nutricion (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- *Correspondence: Jose Lopez-Miranda,
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Abstract
Intravascular catabolism of chylomicrons and very low-density lipoproteins (VLDLs) gives rise to a spectrum of partially lipolyzed remnant particles. Their plasma levels and properties are influenced by lipases, lipid transfer proteins, and content of exchangeable lipoproteins. Particularly important among the latter are apoE, which mediates hepatic binding and uptake of remnants, and apoCIII, which can retard this process. In the course of their plasma transit, remnants can acquire pathologic properties that promote the development of atherosclerotic cardiovascular disease (ASCVD) including increased cholesterol content and transport of thrombogenic and inflammatory mediators. Levels of cholesterol-enriched remnant particles determined by various analytic techniques have been significantly linked to the incidence of ASCVD, most dramatically in dyslipidemic patients homozygous for the apoE2 genetic isoform. Further research is warranted for development of clinical assays that can better capture the pathologic impact of remnant lipoprotein subspecies, and for testing the impact on ASCVD of therapies that reduce their levels.
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Affiliation(s)
- Ronald M Krauss
- University of California, San Francisco, 5700 Martin Luther King, Jr. Way, Oakland CA 94608, USA.
| | - Sarah M King
- University of California, San Francisco, 5700 Martin Luther King, Jr. Way, Oakland CA 94608, USA.
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Li W, Huang Z, Fang W, Wang X, Cai Z, Chen G, Wu W, Chen Z, Wu S, Chen Y. Remnant Cholesterol Variability and Incident Ischemic Stroke in the General Population. Stroke 2022; 53:1934-1941. [PMID: 35543132 DOI: 10.1161/strokeaha.121.037756] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 04/15/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Studies have demonstrated that remnant cholesterol is correlated with the risk of ischemic stroke. However, it is unknown whether visit-to-visit variability in remnant cholesterol concentration affects ischemic stroke. We sought to examine the role of remnant cholesterol variability in the subsequent development of ischemic stroke in the general population. METHODS We performed a post hoc analysis including eligible participants from the Kailuan Study cohort who underwent 3 health examinations and were free of atrial fibrillation, myocardial infarction, stroke, cancer, or known lipid-medication use from 2006 to 2010. Participants were followed up until the end of 2017. Variability was quantified as variability independent of the mean, average real variability, and SD. Multivariate analysis was performed using the Fine and Gray competing risk model to estimate subhazard ratios assuming death as a competing risk. RESULTS The final study cohort comprised 38 556 participants. After a median follow-up of 7.0 years, 1058 individuals were newly diagnosed with ischemic stroke. After adjusting for age (time scale), sex, smoking status, alcohol consumption, physical activity, hypertension, diabetes, family history of cardiovascular disease, body mass index, estimated glomerular filtration rate, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and mean remnant cholesterol, the highest quartile (quartile 4) of variability independent of the mean of remnant cholesterol was associated with an increased ischemic stroke risk compared with the lowest quartile (quartile 1), (subhazard ratio, 1.27 [95% CI, 1.06-1.53]). For each 1-SD increase in variability independent of the mean of remnant cholesterol, the risk increased by 9% (subhazard ratio, 1.09 [95% CI, 1.03-1.16]). The association was also significant using average real variability and SD as indices of variability. CONCLUSIONS Greater remnant cholesterol variability was associated with a higher risk of ischemic stroke in the general population.
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Affiliation(s)
- Weijian Li
- Shantou University Medical College, China
| | - Zegui Huang
- Shantou University Medical College, China (W.L., Z.H., W.F., X.W.)
| | - Wei Fang
- Shantou University Medical College, China (W.L., Z.H., W.F., X.W.)
| | - Xianxuan Wang
- Shantou University Medical College, China (W.L., Z.H., W.F., X.W.)
| | - Zefeng Cai
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, China (Z. Cai, W.W., Z. Chen, Y.C.)
| | - Guanzhi Chen
- China Medical University, Shenyang, China (G.C.)
| | - Weiqiang Wu
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, China (Z. Cai, W.W., Z. Chen, Y.C.)
| | - Zhichao Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, China (Z. Cai, W.W., Z. Chen, Y.C.)
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Youren Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, China
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Li J, Xin Y, Li J, Meng M, Zhou L, Qiu H, Chen H, Li H. Evaluation of Sampson equation for LDL-C in acute coronary syndrome patients: a Chinese population-based cohort study. Lipids Health Dis 2022; 21:39. [PMID: 35436898 PMCID: PMC9016968 DOI: 10.1186/s12944-022-01648-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 04/06/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Low-density lipoprotein cholesterol (LDL-C) is an important cardiovascular disease marker that is used to estimate the risk of acute coronary syndrome in patients. The Sampson equation is an accurate LDL-C equation, but its application in Chinese patients is unclear. METHODS This study enrolled 12,989 consecutive Chinese patients with the acute coronary syndrome (ACS), LDL-C levels were determined by direct standard method and two indirect equations (Friedewald and Sampson). The detection accuracy and consistency of these two equations were compared in patients classified by triglyceride (TG). In addition, the efficiency of the Sampson equation was also evaluated in patients with different comorbidities. RESULTS Patients were divided into six groups according to TG level, and indicated that the Sampson formula was more accurate than the Friedewald formula in all TG spectrums (P < 0.001). The Friedewald formula may underestimate the risk in patients with TG > 400 mg/dL, especially in TG > 800 mg/dL group (r: 0.931 vs. 0.948, 0.666 vs. 0.898, respectively). Compared with the Friedewald equation, the Sampson equation showed more advantages in female, age ≥ 65, body index mass (BMI) < 25, non-smoker, and non-diabetes (0.954 vs. 0.937, 0.956 vs. 0.934, 0.951 vs. 0.939, 0.951 vs. 0.936, and 0.947 vs. 0.938, respectively) than those in male, age < 65, BMI ≥ 25, smoker, and diabetes. CONCLUSIONS Compared with the Friedewald equation, the Sampson equation is more accurate for LDL-C evaluation in Chinese patients diagnosed with ACS, especially in patients with hypertriglyceridemia even in those with TG > 800 mg/dL. Additionally, the Sampson equation demonstrates greater accuracy even in subgroups of various baseline characteristics and comorbidities.
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Affiliation(s)
- Jiayu Li
- Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, No.95 Yong’an Road, Xicheng District, 100050 Beijing, China
| | - Yanguo Xin
- Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, No.95 Yong’an Road, Xicheng District, 100050 Beijing, China
| | - Jingye Li
- Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, No.95 Yong’an Road, Xicheng District, 100050 Beijing, China
| | - Meng Meng
- Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, No.95 Yong’an Road, Xicheng District, 100050 Beijing, China
| | - Li Zhou
- Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, No.95 Yong’an Road, Xicheng District, 100050 Beijing, China
| | - Hui Qiu
- Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, No.95 Yong’an Road, Xicheng District, 100050 Beijing, China
| | - Hui Chen
- Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, No.95 Yong’an Road, Xicheng District, 100050 Beijing, China
| | - Hongwei Li
- Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, No.95 Yong’an Road, Xicheng District, 100050 Beijing, China
- Department of Internal Medical, Medical Health Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Metabolic Disorder Related Cardiovascular Disease, Beijing, China
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Maternal lipid profile in pregnancy and embryonic size: a population-based prospective cohort study. BMC Pregnancy Childbirth 2022; 22:333. [PMID: 35436866 PMCID: PMC9016996 DOI: 10.1186/s12884-022-04647-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 03/29/2022] [Indexed: 12/24/2022] Open
Abstract
Background Lipids are crucial for fetal growth and development. Maternal lipid concentrations are associated with fetal growth in the second and third trimester of pregnancy and with birth outcomes. However, it is unknown if this association starts early in pregnancy or arises later during fetal development. The aim of this study was to investigate the association between the maternal lipid profile in early pregnancy and embryonic size. Methods We included 1474 women from the Generation R Study, a population based prospective birth cohort. Both embryonic size and the maternal lipid profile were measured between 10 weeks + 1 day and 13 weeks + 6 days gestational age. The maternal lipid profile was defined as total cholesterol, triglycerides (TG), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), remnant cholesterol, non-high-density (non-HDL-c) lipoprotein cholesterol concentrations and the triglycerides/high-density lipoprotein (TG/HDL-c) ratio. Additionally, maternal glucose concentrations were assessed. Embryonic size was assessed using crown-rump length (CRL) measurements. Associations were studied with linear regression models, adjusted for confounding factors: maternal age, pre-pregnancy body mass index (BMI), parity, educational level, ethnicity, smoking and folic acid supplement use. Results Triglycerides and remnant cholesterol concentrations are positively associated with embryonic size (fully adjusted models, 0.17 SDS CRL: 95% CI 0.03; 0.30, and 0.17 SDS: 95% CI 0.04; 0.31 per 1 MoM increase, respectively). These associations were not present in women with normal weight (triglycerides and remnant cholesterol: fully adjusted model, 0.44 SDS: 95% CI 0.15; 0.72). Associations between maternal lipid concentrations and embryonic size were not attenuated after adjustment for glucose concentrations. Total cholesterol, HDL-c, LDL-c, non-HDL-c concentrations and the TG/HDL-c ratio were not associated with embryonic size. Conclusions Higher triglycerides and remnant cholesterol concentrations in early pregnancy are associated with increased embryonic size, most notably in overweight women. Trial registration The study protocol has been approved by the Medical Ethics Committee of the Erasmus University Medical Centre (Erasmus MC), Rotterdam (MEC-2007-413). Written informed consent was obtained from all participants. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04647-6.
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Tan Y, Lin Q, Xu J, Zhu L, Guo L, Xie Y, Du X, Zhang S, Wen T, Liu L. Non-fasting Changes in Blood Lipids After Three Daily Meals Within a Day in Chinese Inpatients With Cardiovascular Diseases. Front Cardiovasc Med 2022; 9:799300. [PMID: 35498036 PMCID: PMC9039513 DOI: 10.3389/fcvm.2022.799300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background Non-fasting (i.e., postprandial) lipid detection is recommended in clinical practice. However, the change in blood lipids in Chinese patients with cardiovascular diseases after three daily meals has never been reported yet. Methods Serum levels of blood lipids were measured or calculated in 77 inpatients (48 men and 29 women) at high or very high risk of atherosclerotic cardiovascular disease (ASCVD) in the fasting state and at 4 h after three meals within a day according to their diet habits. Results Female patients showed significantly higher level of high-density lipoprotein cholesterol (HDL-C) than male patients, and the gender difference in other lipid parameters did not reach statistical significance at any time-point. Levels of triglyceride (TG) and remnant cholesterol (RC) increased, while that of low-density lipoprotein cholesterol (LDL-C) decreased significantly after three meals (p < 0.05). Levels of HDL-C, total cholesterol (TC), and non-high-density lipoprotein cholesterol (non-HDL-C) showed smaller changes after three meals. Percent reductions in the non-fasting LDL-C levels after lunch and supper were around 20%, which were greater than that after breakfast. The percent reductions in the non-fasting non-HDL-C levels after three meals were smaller than those in the non-fasting LDL-C levels. Patients with TG level ≥ 2.0 mmol/L (177 mg/dL) after lunch had significantly greater absolute reduction of LDL-C level than those with TG level < 2.0 mmol/L (177 mg/dL) after lunch [–0.69 mmol/L (–27 mg/dL) vs. –0.36 mmol/L (–14 mg/dL), p<0.01]. There was a significant and negative correlation between absolute change in LDL-C level and that in TG level (r = −0.32) or RC level (r = −0.67) after lunch (both p<0.01). Conclusion LDL-C level decreased significantly after three daily meals in Chinese patients at high or very high risk of ASCVD, especially when TG level reached its peak after lunch. Relatively, non-HDL-C level was more stable than LDL-C level postprandially. Therefore, when LDL-C level was measured in the non-fasting state, non-HDL-C level could be evaluated simultaneously to reduce the interference of related factors, such as postprandial hypertriglyceridemia, on detection.
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Affiliation(s)
- Yangrong Tan
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China
- Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Qiuzhen Lin
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China
- Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Jin Xu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China
- Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Liyuan Zhu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China
- Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Liling Guo
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China
- Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Yingying Xie
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China
- Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Xiao Du
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China
- Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Shilan Zhang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China
- Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Tie Wen
- Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Emergency Medicine and Difficult Diseases Institute, The Second Xiangya Hospital, Central South University, Changsha, China
- Tie Wen,
| | - Ling Liu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
- Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China
- Cardiovascular Disease Research Center of Hunan Province, Changsha, China
- *Correspondence: Ling Liu,
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RSSDI consensus recommendations for dyslipidemia management in diabetes mellitus. Int J Diabetes Dev Ctries 2022. [DOI: 10.1007/s13410-022-01063-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Wilson DP, Williams L, Kavey REW. Hypertriglyceridemia in Youth. J Pediatr 2022; 243:200-207. [PMID: 34929246 DOI: 10.1016/j.jpeds.2021.12.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 12/01/2021] [Accepted: 12/13/2021] [Indexed: 12/11/2022]
Affiliation(s)
- Don P Wilson
- Pediatric Cardiovascular Health and Risk Prevention Program, Pediatric Endocrinology and Diabetes, Cook Children's Medical Center, Fort Worth, TX.
| | - Lauren Williams
- Pediatric Cardiovascular Health and Risk Prevention Program, Pediatric Endocrinology and Diabetes, Cook Children's Medical Center, Fort Worth, TX
| | - Rae-Ellen W Kavey
- Department of Pediatrics, University of Rochester School of Medicine, Rochester, NY
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Qureshi F, Soo J, Chen Y, Roy B, Lloyd-Jones DM, Kubzansky LD, Boehm JK. Optimism and Lipid Profiles in Midlife: A 15-Year Study of Black and White Adults. Am J Prev Med 2022; 62:e169-e177. [PMID: 35067361 PMCID: PMC8863618 DOI: 10.1016/j.amepre.2021.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 09/03/2021] [Accepted: 09/26/2021] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Optimism is associated with better cardiovascular health, yet little is known about the underlying mechanisms and whether protective relationships are consistently observed across diverse groups. This study examines optimism's association with lipid profiles over time and separately among Black and White men and women. METHODS Data were from 3,206 middle-aged adults in the Coronary Artery Risk Development in Young Adults study. Optimism was measured in 2000-2001 using the Revised Life Orientation Test. Triglyceride, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol measurements were obtained at 5-year intervals through 2015-2016. Linear mixed models evaluated relationships between optimism and lipids, adjusting for covariates, including prebaseline lipids. Subgroup differences were examined using interaction terms and stratification. All analyses were conducted in 2020. RESULTS Higher optimism was associated with both lower baseline total cholesterol (β= -2.33, 95% CI= -4.31, -0.36) and low-density lipoprotein cholesterol levels (β= -1.93, 95% CI= -3.65, -0.21) and a more rapid incremental increase in both markers over time (total cholesterol: β=0.09, 95% CI=0.00, 0.18; low-density lipoprotein cholesterol: β=0.09, 95% CI=0.01, 0.16). No associations were apparent with baseline triglycerides, high-density lipoprotein cholesterol, or changes in either lipid over time. Tests for interaction only found evidence of heterogeneous associations with baseline triglyceride levels, but stratified models hinted at stronger protective associations with baseline levels of total cholesterol and low-density lipoprotein cholesterol among White women. CONCLUSIONS Optimism may help diverse individuals establish healthy total cholesterol and low-density lipoprotein cholesterol levels before midlife. Although associations were largely consistent across subgroups, stronger associations among White men and White women highlight a need to study optimism's health impact in diverse samples.
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Affiliation(s)
- Farah Qureshi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Jackie Soo
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Ying Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Brita Roy
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut; Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
| | - Donald M Lloyd-Jones
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Julia K Boehm
- Department of Psychology, Chapman University, Orange, California
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Lebrun LJ, Moreira S, Tavernier A, Niot I. Postprandial consequences of lipid absorption in the onset of obesity: Role of intestinal CD36. Biochim Biophys Acta Mol Cell Biol Lipids 2022; 1867:159154. [DOI: 10.1016/j.bbalip.2022.159154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 10/18/2022]
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Hou X, Song A, Guan Y, Tian P, Ren L, Tang Y, Wang C, Gao L, Song G, Xing X. Identification of the Chinese Population That Can Benefit Most From Postprandial Lipid Testing: Validation of the Use of Oral Fat Tolerance Testing in Clinical Practice. Front Endocrinol (Lausanne) 2022; 13:831435. [PMID: 35250883 PMCID: PMC8894673 DOI: 10.3389/fendo.2022.831435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 01/20/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Dyslipidemia has become increasingly prevalent in recent decades. Blood lipid concentrations are significantly influenced by diet; however, postprandial triglyceride concentration (PTG) is not often measured. PTG can reflect the risks of diabetes and cardiovascular disease, but not all individuals would benefit from PTG testing. OBJECTIVE The aim of the present study was to determine the PTG response in a Chinese cohort and identify who would benefit from diagnostic PTG measurement. METHODS A total of 400 Chinese adults were enrolled and underwent oral fat tolerance test (OFTT), which was well tolerated. The participants were assigned to groups according to their fasting triglyceride concentration to evaluate the usefulness of PTG testing. A PTG concentration > 2.5 mmol/L was defined as high (HPTG). RESULTS Of the 400 participants, 78.9% showed an undesirable PTG response. Those with FTG ≥1.0 mmol/L had a delayed PTG peak and higher peak values. Seventy-five percent of those with 1.0 mmol/L ≤FTG <1.7 mmol/L had HPTG, of whom 18.6% had impaired glucose tolerance. CONCLUSIONS The present data confirm the previously reported predictive value of PTG testing. Moreover, the findings indicate that Chinese people with FTGs of 1.0 -1.7 mmol/L may benefit most from the identification of postprandial hyperlipidemia through OFTT because more than half of them have occult HPTG, which may require treatment. Thus, the detection of HPTG using an OFTT represents a useful means of identifying dyslipidemia and abnormal glucose metabolism early. CLINICAL TRIAL REGISTRATION [http://www.chictr.org.cn/index.aspx], identifier ChiCTR1800019514.
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Affiliation(s)
- Xiaoyu Hou
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China
| | - An Song
- Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yunpeng Guan
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China
| | - Peipei Tian
- Department of Endocrinology, Cangzhou Central Hospital, Cangzhou, China
| | - Luping Ren
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China
| | - Yong Tang
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China
| | - Chao Wang
- Hebei Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, China
| | - Ling Gao
- Department of Endocrinology and Metabolism, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Guangyao Song
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China
| | - Xiaoping Xing
- Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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44
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Wilson PWF, Jacobson TA, Martin SS, Jackson EJ, Le NA, Davidson MH, Vesper HW, Frikke-Schmidt R, Ballantyne CM, Remaley AT. Lipid measurements in the management of cardiovascular diseases: Practical recommendations a scientific statement from the national lipid association writing group. J Clin Lipidol 2021; 15:629-648. [PMID: 34802986 DOI: 10.1016/j.jacl.2021.09.046] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 01/31/2023]
Abstract
Lipoprotein measurements are pivotal in the management of patients at risk for atherosclerotic coronary heart disease (CHD) with myocardial infarction and coronary death as the main outcomes, and for atherosclerotic cardiovascular disease (ASCVD), which includes CHD and stroke. Recent developments and changes in guidelines affect optimization of using lipid measures as cardiovascular biomarkers. This scientific statement reviews the pre-analytical, analytical, post-analytical, and clinical aspects of lipoprotein measurements. Highlights include the following: i) It is acceptable to screen with nonfasting lipids. ii) non-high-density lipoprotein HDL-cholesterol (non-HDL-C) is measured reliably in either the fasting or the nonfasting state and can effectively guide ASCVD prevention. iii) low density lipoprotein cholesterol (LDL-C) can be estimated from total cholesterol, high density lipoprotein cholesterol (HDL-C), and triglyceride (TG) measurements. For patients with LDL-C>100 mg/dL and TG ≤150 mg/dL it is reasonable to use the Friedewald formula. However, for those with TG 150-400 mg/dL the Friedewald formula for LDL-C estimation is less accurate. The Martin/Hopkins method is recommended for LDL-C estimation throughout the range of LDL-C levels and up to TG levels of 399 mg/dL. For TG levels ≥400 mg/dL LDL-C estimating equations are currently not recommended and newer methods are being evaluated. iv) When LDL-C or TG screening results are abnormal the clinician should consider obtaining fasting lipids. v) Advanced lipoprotein tests using apolipoprotein B (apoB), LDL Particle Number (LDL-P) or remnant cholesterol may help to guide therapeutic decisions in select patients, but data are limited for patients already on lipid lowering therapy with low LDL-C levels. Better harmonization of advanced lipid measurement methods is needed. Lipid measurements are recommended 4-12 weeks after a change in lipid treatment. Lipid laboratory reports should denote desirable values and specifically identify extremely elevated LDL-C levels (≥190 mg/dL at any age or ≥160 mg/dL in children) as severe hypercholesterolemia. Potentially actionable abnormal lipid test results, including fasting triglycerides (TG) ≥500 mg/dL, should be reported as hypertriglyceridemia. Appropriate use and reporting of lipid tests should improve their utility in the management of persons at high risk for ASCVD events.
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Affiliation(s)
- Peter W F Wilson
- Emory University School of Medicine, Atlanta, GA, United States; Atlanta Veterans Affairs Medical Center, Atlanta, GA, United States.
| | | | - Seth S Martin
- Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | | | - N-Anh Le
- Atlanta Veterans Affairs Medical Center, Atlanta, GA, United States
| | | | - Hubert W Vesper
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Ruth Frikke-Schmidt
- Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Alan T Remaley
- National Heart, Lung and Blood Institute, Bethesda, MD, United States
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45
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Soohoo M, Hashemi L, Hsiung JT, Moradi H, Budoff MJ, Kovesdy CP, Kalantar-Zadeh K, Streja E. Risk of Atherosclerotic Cardiovascular Disease and Nonatherosclerotic Cardiovascular Disease Hospitalizations for Triglycerides Across Chronic Kidney Disease Stages Among 2.9 Million US Veterans. J Am Heart Assoc 2021; 10:e022988. [PMID: 34729994 PMCID: PMC9075381 DOI: 10.1161/jaha.121.022988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background High triglycerides are associated with atherosclerotic cardiovascular disease (ASCVD) risks. Among patients with advanced chronic kidney disease (CKD), the association of elevated triglycerides with mortality is diminished and, thus, we investigated the relationship of triglycerides with ASCVD and non‐ASCVD hospitalizations across CKD stages. Methods and Results The cohort comprised 2 963 176 veterans who received care in 2004 to 2006 (baseline) and were followed up to 2014. Using Cox models, we evaluated baseline and time‐varying triglycerides with time to ASCVD or non‐ASCVD hospitalizations, stratified by baseline CKD stage, and adjusted for demographics and baseline or time‐updated clinical characteristics. The cohort mean±SD age was 63±14 years, with a baseline median (interquartile range) triglycerides level of 127 (87–189) mg/dL, and a quarter had prevalent CKD. There was a linear association between baseline triglycerides and ASCVD risk; however, the risk with high triglycerides ≥240 mg/dL attenuated with worsening CKD stages (reference: triglycerides 120 to <160 mg/dL). Baseline triglycerides were associated with a U‐shaped relationship for non‐ASCVD events in patients with CKD 3A to 3B. Patients with late‐stage CKD had lower to null relationships between baseline triglycerides and non‐ASCVD events. Time‐varying triglycerides associations with ASCVD were similar to baseline analyses. Yet, the time‐varying triglycerides relationship with non‐ASCVD events was inverse and linear, where elevated triglycerides were associated with lower risks. Conclusions Associations of higher triglycerides with ASCVD and non‐ASCVD events declined across advancing CKD stages, where a lower to null risk was observed in patients with advanced CKD. Studies are needed to examine the impact of advanced CKD on triglycerides metabolism and its association with outcomes in this high‐risk population.
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Affiliation(s)
- Melissa Soohoo
- Division of Nephrology and Hypertension Harold Simmons Center for Kidney Disease Research and Epidemiology University of California Irvine Medical Center Orange CA.,Nephrology Section Tibor Rubin Veterans Affairs Medical Center Long Beach CA
| | - Leila Hashemi
- Department of General Internal Medicine Greater Los Angeles Healthcare System Los Angeles CA.,David Geffen School of Medicine University of California Los Angeles Los Angeles CA
| | - Jui-Ting Hsiung
- Division of Nephrology and Hypertension Harold Simmons Center for Kidney Disease Research and Epidemiology University of California Irvine Medical Center Orange CA.,Nephrology Section Tibor Rubin Veterans Affairs Medical Center Long Beach CA
| | - Hamid Moradi
- Division of Nephrology and Hypertension Harold Simmons Center for Kidney Disease Research and Epidemiology University of California Irvine Medical Center Orange CA.,Nephrology Section Tibor Rubin Veterans Affairs Medical Center Long Beach CA
| | - Matthew J Budoff
- Division of Cardiology The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center Torrance CA
| | - Csaba P Kovesdy
- Nephrology Section Memphis Veterans Affairs Medical Center Memphis TN.,Division of Nephrology University of Tennessee Health Science Center Memphis TN
| | - Kamyar Kalantar-Zadeh
- Division of Nephrology and Hypertension Harold Simmons Center for Kidney Disease Research and Epidemiology University of California Irvine Medical Center Orange CA.,Nephrology Section Tibor Rubin Veterans Affairs Medical Center Long Beach CA
| | - Elani Streja
- Division of Nephrology and Hypertension Harold Simmons Center for Kidney Disease Research and Epidemiology University of California Irvine Medical Center Orange CA.,Nephrology Section Tibor Rubin Veterans Affairs Medical Center Long Beach CA
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46
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Boutot ME, Whitcomb BW, Abdelouahab N, Baccarelli AA, Boivin A, Caku A, Gillet V, Martinez G, Pasquier JC, Zhu J, Takser L, St-Cyr L, Suvorov A. In Utero Exposure to Persistent Organic Pollutants and Childhood Lipid Levels. Metabolites 2021; 11:657. [PMID: 34677372 PMCID: PMC8540619 DOI: 10.3390/metabo11100657] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 12/15/2022] Open
Abstract
Animal studies have shown that developmental exposures to polybrominated diphenyl ethers (PBDE) permanently affect blood/liver balance of lipids. No human study has evaluated associations between in utero exposures to persistent organic pollutants (POPs) and later life lipid metabolism. In this pilot, maternal plasma levels of PBDEs (BDE-47, BDE-99, BDE-100, and BDE-153) and polychlorinated biphenyls (PCB-138, PCB-153, and PCB-180) were determined at delivery in participants of GESTation and Environment (GESTE) cohort. Total cholesterol (TCh), triglycerides (TG), low- and high-density lipoproteins (LDL-C and HDL-C), total lipids (TL), and PBDEs were determined in serum of 147 children at ages 6-7. General linear regression was used to estimate the relationship between maternal POPs and child lipid levels with adjustment for potential confounders, and adjustment for childhood POPs. In utero BDE-99 was associated with lower childhood levels of TG (p = 0.003), and non-significantly with HDL-C (p = 0.06) and TL (p = 0.07). Maternal PCB-138 was associated with lower childhood levels of TG (p = 0.04), LDL-C (p = 0.04), and TL (p = 0.02). Our data indicate that in utero exposures to POPs may be associated with long lasting decrease in circulating lipids in children, suggesting increased lipid accumulation in the liver, a mechanism involved in NAFLD development, consistent with previously reported animal data.
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Affiliation(s)
- Maegan E. Boutot
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA 01003, USA; (M.E.B.); (B.W.W.)
| | - Brian W. Whitcomb
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA 01003, USA; (M.E.B.); (B.W.W.)
| | - Nadia Abdelouahab
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, Sherbrooke University, Sherbrooke, QC J1H 5N4, Canada; (N.A.); (J.-C.P.)
| | - Andrea A. Baccarelli
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA;
| | - Amélie Boivin
- Department of Pediatrics, Faculty of Medicine and Health Sciences, Sherbrooke University, Sherbrooke, QC J1H 5N4, Canada; (A.B.); (V.G.); (L.S.-C.)
| | - Artuela Caku
- Department of Biochemistry and Functional Genomics, Faculty of Medicine and Health Sciences, Sherbrooke University, Sherbrooke, QC J1H 5N4, Canada;
| | - Virginie Gillet
- Department of Pediatrics, Faculty of Medicine and Health Sciences, Sherbrooke University, Sherbrooke, QC J1H 5N4, Canada; (A.B.); (V.G.); (L.S.-C.)
| | - Guillaume Martinez
- Department of Chemistry, Faculty of Sciences, Sherbrooke, QC J1K 2R1, Canada;
| | - Jean-Charles Pasquier
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, Sherbrooke University, Sherbrooke, QC J1H 5N4, Canada; (N.A.); (J.-C.P.)
| | - Jiping Zhu
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON K1A 0K9, Canada;
| | - Larissa Takser
- Department of Pediatrics & Department of Psychiatry, Faculty of Medicine and Health Sciences, Sherbrooke University, Sherbrooke, QC J1H 5N4, Canada;
| | - Lindsay St-Cyr
- Department of Pediatrics, Faculty of Medicine and Health Sciences, Sherbrooke University, Sherbrooke, QC J1H 5N4, Canada; (A.B.); (V.G.); (L.S.-C.)
| | - Alexander Suvorov
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA 01003, USA; (M.E.B.); (B.W.W.)
- Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA 01003, USA
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47
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Wilson SM, Maes AP, Yeoman CJ, Walk ST, Miles MP. Determinants of the postprandial triglyceride response to a high-fat meal in healthy overweight and obese adults. Lipids Health Dis 2021; 20:107. [PMID: 34544430 PMCID: PMC8451105 DOI: 10.1186/s12944-021-01543-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/03/2021] [Indexed: 12/21/2022] Open
Abstract
Background Dyslipidemia is a feature of impaired metabolic health in conjunction with impaired glucose metabolism and central obesity. However, the contribution of factors to postprandial lipemia in healthy but metabolically at-risk adults is not well understood. We investigated the collective contribution of several physiologic and lifestyle factors to postprandial triglyceride (TG) response to a high-fat meal in healthy, overweight and obese adults. Methods Overweight and obese adults (n = 35) underwent a high-fat meal challenge with blood sampled at fasting and hourly in the 4-hour postprandial period after a breakfast containing 50 g fat. Incremental area under the curve (iAUC) and postprandial magnitude for TG were calculated and data analyzed using a linear model with physiologic and lifestyle characteristics as explanatory variables. Model reduction was used to assess which explanatory variables contributed most to the postprandial TG response. Results TG responses to a high-fat meal were variable between individuals, with approximately 57 % of participants exceeded the nonfasting threshold for hypertriglyceridemia. Visceral adiposity was the strongest predictor of TG iAUC (β = 0.53, p = 0.01), followed by aerobic exercise frequency (β = 0.31, p = 0.05), insulin resistance based on HOMA-IR (β = 0.30, p = 0.04), and relative exercise intensity at which substrate utilization crossover occurred (β = 0.05, p = 0.04). For postprandial TG magnitude, visceral adiposity was a strong predictor (β = 0.43, p < 0.001) followed by aerobic exercise frequency (β = 0.23, p = 0.01), and exercise intensity for substrate utilization crossover (β = 0.53, p = 0.01). Conclusions Postprandial TG responses to a high-fat meal was partially explained by several physiologic and lifestyle characteristics, including visceral adiposity, insulin resistance, aerobic exercise frequency, and relative substrate utilization crossover during exercise. Trial Registration ClinicalTrials.gov, NCT04128839, Registered 16 October 2019 – Retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1186/s12944-021-01543-4.
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Affiliation(s)
- Stephanie M Wilson
- Department of Health and Human Development, Montana State University, Box 173540, 20 Herrick Hall, MT, 59717, Bozeman, USA
| | - Adam P Maes
- School of Public and Community Health Sciences, University of Montana, Missoula, USA
| | - Carl J Yeoman
- Department of Animal and Range Sciences, Montana State University, Bozeman, USA
| | - Seth T Walk
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, USA
| | - Mary P Miles
- Department of Health and Human Development, Montana State University, Box 173540, 20 Herrick Hall, MT, 59717, Bozeman, USA.
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48
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Jacome-Sosa M, Hu Q, Manrique-Acevedo CM, Phair RD, Parks EJ. Human intestinal lipid storage through sequential meals reveals faster dinner appearance is associated with hyperlipidemia. JCI Insight 2021; 6:e148378. [PMID: 34369385 PMCID: PMC8489663 DOI: 10.1172/jci.insight.148378] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/30/2021] [Indexed: 12/14/2022] Open
Abstract
Background It is increasingly recognized that intestinal cells can store lipids after a meal, yet the effect of this phenomenon on lipid absorption patterns in insulin resistance remains unknown. Methods The kinetics of meal fat appearance were measured in insulin-sensitive (IS, n = 8) and insulin-resistant (IR, n = 8) subjects after sequential, isotopically labeled lunch and dinner meals. Plasma dynamics on triacylglycerol-rich (TAG-rich) lipoproteins and plasma hormones were analyzed using a nonlinear, non–steady state kinetic model. Results At the onset of dinner, IS subjects showed an abrupt plasma appearance of lunch lipid consistent with the “second-meal effect,” followed by slower appearance of dinner fat in plasma, resulting in reduced accumulation of dinner TAG of 48% compared with lunch. By contrast, IR subjects exhibited faster meal TAG appearance rates after both lunch and dinner. This effect of lower enterocyte storage between meals was associated with greater nocturnal and next-morning hyperlipidemia. The biochemical data and the kinetic analysis of second-meal effect dynamics are consistent with rapid secretion of stored TAG bypassing lipolysis and resynthesis. In addition, the data are consistent with a role for the diurnal pattern of plasma leptin in regulating the processing of dietary lipid. Conclusion These data support the concept that intestinal lipid storage may be physiologically beneficial in IS subjects. Trial registration ClinicalTrials.gov NCT02020343. Funding This study was supported by a grant from the American Diabetes Association (grant 1-13-TS-12).
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Affiliation(s)
| | - Qiong Hu
- Department of Nutrition and Exercise Physiology and
| | | | - Robert D Phair
- Integrative Bioinformatics, Inc., Mountain View, California, USA
| | - Elizabeth J Parks
- Department of Nutrition and Exercise Physiology and.,Division of Gastroenterology and Hepatology, School of Medicine, University of Missouri, Columbia, Missouri, USA
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49
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Lin Q, Fu Y, Zang X, Liu Q, Liu L. The Role of Fasting LDL-C Levels in Their Non-fasting Reduction in Patients With Coronary Heart Disease. Front Cardiovasc Med 2021; 8:686234. [PMID: 34222380 PMCID: PMC8241924 DOI: 10.3389/fcvm.2021.686234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/17/2021] [Indexed: 11/13/2022] Open
Abstract
The level of low-density lipoprotein cholesterol (LDL-C) decreases to a certain extent after daily meals; however, the influencing factor of this phenomenon has not been fully elucidated. This study included 447 patients with coronary heart disease (CHD). Serum levels of blood lipid parameters at 0, 2, and 4 hours (h) after a daily breakfast were monitored in all subjects. The levels of total cholesterol (TC), LDL-C, high-density lipoprotein cholesterol (HDL-C) and non-HDL-C significantly decreased, while those of triglycerides (TG) and remnant cholesterol (RC) significantly increased from baseline to 4 h in both male and female patients (P < 0.05). Multiple linear regression analysis showed that fasting LDL-C level, the non-fasting change in RC level at 4 h and fasting TG level were significant predictors of the non-fasting change in LDL-C level at 4 h in patients with CHD, and fasting LDL-C level was the most significantly associated with the non-fasting change in LDL-C level. Patients with lower levels of fasting LDL-C had smaller non-fasting changes in LDL-C levels. When the fasting LDL-C level was <1.4 mmol/L, both absolute reduction and percent reduction in LDL-C level at 4 h were almost zero, which means that the non-fasting LDL-C level at 4 h was approximately equivalent to its fasting value (P < 0.05). This result indicated that the non-fasting changes in LDL-C levels were influenced by fasting LDL-C levels in patients with CHD. When the fasting LDL-C level was <1.4 mmol/L, the non-fasting LDL-C level could replace the fasting value to guide treatment.
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Affiliation(s)
- Qiuzhen Lin
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Yan Fu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - XueYan Zang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Qiming Liu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
| | - Ling Liu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.,Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China.,Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, China.,Cardiovascular Disease Research Center of Hunan Province, Changsha, China
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50
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Langlois MR, Nordestgaard BG, Langsted A, Chapman MJ, Aakre KM, Baum H, Borén J, Bruckert E, Catapano A, Cobbaert C, Collinson P, Descamps OS, Duff CJ, von Eckardstein A, Hammerer-Lercher A, Kamstrup PR, Kolovou G, Kronenberg F, Mora S, Pulkki K, Remaley AT, Rifai N, Ros E, Stankovic S, Stavljenic-Rukavina A, Sypniewska G, Watts GF, Wiklund O, Laitinen P. Quantifying atherogenic lipoproteins for lipid-lowering strategies: consensus-based recommendations from EAS and EFLM. Clin Chem Lab Med 2021; 58:496-517. [PMID: 31855562 DOI: 10.1515/cclm-2019-1253] [Citation(s) in RCA: 91] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Indexed: 12/15/2022]
Abstract
The joint consensus panel of the European Atherosclerosis Society (EAS) and the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) recently addressed present and future challenges in the laboratory diagnostics of atherogenic lipoproteins. Total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDLC), LDL cholesterol (LDLC), and calculated non-HDLC (=total - HDLC) constitute the primary lipid panel for estimating risk of atherosclerotic cardiovascular disease (ASCVD) and can be measured in the nonfasting state. LDLC is the primary target of lipid-lowering therapies. For on-treatment follow-up, LDLC shall be measured or calculated by the same method to attenuate errors in treatment decisions due to marked between-method variations. Lipoprotein(a) [Lp(a)]-cholesterol is part of measured or calculated LDLC and should be estimated at least once in all patients at risk of ASCVD, especially in those whose LDLC declines poorly upon statin treatment. Residual risk of ASCVD even under optimal LDL-lowering treatment should be also assessed by non-HDLC or apolipoprotein B (apoB), especially in patients with mild-to-moderate hypertriglyceridemia (2-10 mmol/L). Non-HDLC includes the assessment of remnant lipoprotein cholesterol and shall be reported in all standard lipid panels. Additional apoB measurement can detect elevated LDL particle (LDLP) numbers often unidentified on the basis of LDLC alone. Reference intervals of lipids, lipoproteins, and apolipoproteins are reported for European men and women aged 20-100 years. However, laboratories shall flag abnormal lipid values with reference to therapeutic decision thresholds.
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Affiliation(s)
- Michel R Langlois
- Department of Laboratory Medicine, AZ St-Jan, Ruddershove 10, 8000 Brugge, Belgium.,University of Ghent, Ghent, Belgium
| | - Børge G Nordestgaard
- Herlev and Gentofte Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Anne Langsted
- Herlev and Gentofte Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - M John Chapman
- National Institute for Health and Medical Research (INSERM), Paris, France.,Endocrinology-Metabolism Service, Pitié-Salpetriere University Hospital, Paris, France
| | - Kristin M Aakre
- Hormone Laboratory, Haukeland University Hospital, Bergen, Norway
| | - Hannsjörg Baum
- Institute for Laboratory Medicine, Mikrobiologie und Blutdepot, Regionale Kliniken Holding RKH GmbH, Ludwigsburg, Germany
| | - Jan Borén
- Institute of Medicine, Sahlgrenska Academy at Göteborg University, Gothenburg, Sweden.,Wallenberg Laboratory for Cardiovascular and Metabolic Research, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Eric Bruckert
- Department of Endocrinology and Prevention of Cardiovascular Disease, Pitié-Salpetriere University Hospital, Paris, France
| | - Alberico Catapano
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy.,IRCCS Multimedica, Milan, Italy
| | - Christa Cobbaert
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Paul Collinson
- Department of Clinical Blood Sciences, St George's University Hospitals NHS Foundation Trust and St George's University of London, London, UK.,Department of Cardiology, St George's University Hospitals NHS Foundation Trust and St George's University of London, London, UK
| | - Olivier S Descamps
- Department of Internal Medicine, Centres Hospitaliers Jolimont, Haine-Saint-Paul, Belgium.,Department of Cardiology, UCL Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Christopher J Duff
- Department of Clinical Biochemistry, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
| | | | | | - Pia R Kamstrup
- Herlev and Gentofte Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Genovefa Kolovou
- Cardiology Department, Onassis Cardiac Surgery Center, Athens, Greece
| | - Florian Kronenberg
- Department of Medical Genetics, Molecular and Clinical Pharmacology, Division of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Samia Mora
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kari Pulkki
- Department of Clinical Chemistry, University of Turku and Turku University Hospital, Turku, Finland
| | - Alan T Remaley
- Lipoprotein Metabolism Section, Cardiovascular-Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Nader Rifai
- Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Emilio Ros
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clínic, Barcelona, Spain.,Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Sanja Stankovic
- Center for Medical Biochemistry, Clinical Center of Serbia, Belgrade, Serbia
| | | | - Grazyna Sypniewska
- Department of Laboratory Medicine, Collegium Medicum, NC University, Bydgoszcz, Poland
| | - Gerald F Watts
- Lipid Disorders Clinic, Department of Cardiology, Royal Perth Hospital, University of Western Australia, Perth, Australia
| | - Olov Wiklund
- Institute of Medicine, Sahlgrenska Academy at Göteborg University, Gothenburg, Sweden.,Wallenberg Laboratory for Cardiovascular and Metabolic Research, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Päivi Laitinen
- Department of Clinical Chemistry, HUSLAB, Helsinki University Hospital, Helsinki, Finland
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